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General NPI Number Information
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NPI Number | 1881811214
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Entity Type | Organization
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Legal Business Name | MADDEN FAMILY CHIROPRACTIC PA
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Dates
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Enumeration Date | 04/19/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1201 S I H 35 STE 103
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City | ROUND ROCK
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State | TX
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Zip | 78664-6646
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Country | US
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Telephone | 512-255-0401
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Fax | 512-255-0441
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Provider Business Mailing Address
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Address Line | 1201 S I H 35 STE 103
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City | ROUND ROCK
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State | TX
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Zip | 78664-6646
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JOHN MADDEN
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Credential |
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Telephone | 512-255-0401
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 10046
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License Number State | TX
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