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General NPI Number Information
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NPI Number | 1851693618
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Entity Type | Organization
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Legal Business Name | MICHAEL D. VENNELL DC PA
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Dates
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Enumeration Date | 11/30/2010
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Last Update Date | 11/07/2018
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Provider Practice Location Address
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Address Line | 3501 SONCY ST. STE #1
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City | AMARILLO
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State | TX
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Zip | 79119-6405
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Country | US
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Telephone | 806-356-7291
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Fax | 806-553-1598
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Provider Business Mailing Address
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Address Line | 3501 SONCY ST. STE #1
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City | AMARILLO
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State | TX
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Zip | 79119-6405
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Country | US
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Telephone | 806-356-7291
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Fax | 806-553-1598
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Authorized Official
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Title or Position | OWNER
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Name | DR. MICHAEL D VENNELL
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Credential | D.C.
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Telephone | 806-356-7291
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number | 11599
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License Number State | TX
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