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General NPI Number Information
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NPI Number | 1912613274
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Entity Type | Individual
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Provider Name | COLTON JOEL O'BRIEN DC
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Gender | Male
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Dates
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Enumeration Date | 01/30/2023
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Last Update Date | 01/30/2023
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Provider Practice Location Address
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Address Line | 101 W MCDERMOTT DR STE 122
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City | ALLEN
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State | TX
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Zip | 75013-2751
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Country | US
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Telephone | 806-316-1091
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Fax |
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Provider Business Mailing Address
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Address Line | 4000 PARKERSIDE CENTER BLVD, #2701
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City | FARMERS BRANCH
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State | TX
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Zip | 75244
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Country | US
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Telephone | 806-316-1091
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 15462
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License Number State | TX
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