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General NPI Number Information
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NPI Number | 1942433982
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Entity Type | Organization
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Legal Business Name | GRANBURY CHIROPRACTIC WELLNESS CENTER
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Dates
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Enumeration Date | 08/25/2009
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Last Update Date | 08/25/2009
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Provider Practice Location Address
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Address Line | 3415 E HWY 377
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City | GRANBURY
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State | TX
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Zip | 76049-7419
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Country | US
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Telephone | 817-579-7722
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Fax | 817-579-7712
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Provider Business Mailing Address
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Address Line | 3415 E HWY 377
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City | GRANBURY
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State | TX
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Zip | 76049
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Country | US
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Telephone | 817-579-7722
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Fax | 817-579-7712
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. CRAIG ALLEN BECKWITH
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Credential | DC
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Telephone | 817-579-7722
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | DC6811
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License Number State | TX
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