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General NPI Number Information
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NPI Number | 1922132000
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Entity Type | Organization
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Legal Business Name | PLANO INJURY REHAB
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Dates
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Enumeration Date | 03/14/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 905 W PARKER RD
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City | PLANO
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State | TX
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Zip | 75023-7122
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Country | US
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Telephone | 972-964-7696
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Fax |
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Provider Business Mailing Address
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Address Line | 4025 RIVER BRANCH TRAIL
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City | PLANO
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State | TX
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Zip | 75024-3795
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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 | BUS. OPERATIONS MGR.
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Name | KENYA SALLIERGRAY
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Credential |
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Telephone | 214-206-4952
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NR0400X
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Taxonomy Name | Rehabilitation Chiropractor
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License Number | 8224
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License Number State | TX
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