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General NPI Number Information
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NPI Number | 1972166999
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Entity Type | Organization
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Legal Business Name | REFORM CHIROPRACTIC LLC
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Dates
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Enumeration Date | 04/16/2019
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Last Update Date | 04/16/2019
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Provider Practice Location Address
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Address Line | 7700 ELDORADO PKWY STE 100
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City | MCKINNEY
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State | TX
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Zip | 75070-5737
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Country | US
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Telephone | 972-540-0608
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Fax |
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Provider Business Mailing Address
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Address Line | 5201 SANDSTONE LN
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City | MCKINNEY
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State | TX
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Zip | 75072-9315
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Country | US
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Telephone | 858-344-8003
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Fax |
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Authorized Official
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Title or Position | OWNER/CHIROPRACTOR
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Name | DR. MATTHEW KENNETH DAVIS
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Credential | DC
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Telephone | 858-344-8003
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NP0017X
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Taxonomy Name | Pediatric Chiropractor
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License Number |
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License Number State |
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