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General NPI Number Information
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NPI Number | 1952671760
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Entity Type | Organization
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Legal Business Name | OAK HILLS CHIROPRACTIC LLC
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Dates
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Enumeration Date | 01/10/2012
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Last Update Date | 01/10/2012
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Provider Practice Location Address
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Address Line | 13402 WEST AVE STE 103
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City | SAN ANTONIO
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State | TX
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Zip | 78216-2029
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Country | US
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Telephone | 210-460-6264
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Fax | 210-460-6263
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Provider Business Mailing Address
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Address Line | 13402 WEST AVE STE 103
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City | SAN ANTONIO
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State | TX
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Zip | 78216-2029
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Country | US
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Telephone | 210-460-6264
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Fax | 210-460-6263
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Authorized Official
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Title or Position | MEMBER
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Name | DR. CLAYTON A HANSEN
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Credential | D.C.
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Telephone | 210-460-6264
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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 | 11629
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License Number State | TX
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