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General NPI Number Information
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NPI Number | 1922259571
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Entity Type | Organization
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Legal Business Name | STONE CREEK FAMILY CHIROPRACTIC
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Dates
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Enumeration Date | 10/01/2008
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Last Update Date | 10/01/2008
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Provider Practice Location Address
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Address Line | 2200 MORRISS RD SUITE 200
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City | FLOWER MOUND
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State | TX
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Zip | 75028-3598
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Country | US
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Telephone | 866-933-1381
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Fax |
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Provider Business Mailing Address
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Address Line | 2200 MORRISS RD SUITE 200
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City | FLOWER MOUND
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State | TX
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Zip | 75028-3598
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Country | US
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Telephone | 866-933-1381
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Fax |
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Authorized Official
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Title or Position | CONSULTANT
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Name | JACQUE KEIL
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Credential |
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Telephone | 866-933-1381
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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 | 8761
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License Number State | TX
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