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General NPI Number Information
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NPI Number | 1891829990
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Entity Type | Organization
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Legal Business Name | POWER FAMILY CHIROPRACTIC, P.C.
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Dates
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Enumeration Date | 03/14/2007
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Last Update Date | 12/23/2012
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Provider Practice Location Address
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Address Line | 3419A JOHNSON AVE
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City | SAN ANGELO
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State | TX
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Zip | 76904-5554
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Country | US
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Telephone | 325-812-8140
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Fax |
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Provider Business Mailing Address
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Address Line | 9582 FLOYD LN
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City | SAN ANGELO
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State | TX
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Zip | 76901-9729
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Country | US
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Telephone | 325-812-8140
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. JEFFREY GRAY POWER
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Credential | D.C.
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Telephone | 325-812-8140
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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 | 6747
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License Number State | TX
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