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General NPI Number Information
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NPI Number | 1982482535
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Entity Type | Organization
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Legal Business Name | CHIRO LIFE HEALTH AND WELLNESS, PLLC
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Dates
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Enumeration Date | 09/15/2023
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Last Update Date | 09/15/2023
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Provider Practice Location Address
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Address Line | 1809 K AVE STE 1
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City | PLANO
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State | TX
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Zip | 75074-5907
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Country | US
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Telephone | 469-596-7699
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Fax | 469-929-9250
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Provider Business Mailing Address
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Address Line | 2701 W 15TH ST STE 514
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City | PLANO
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State | TX
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Zip | 75075-7523
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Country | US
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Telephone | 469-596-7699
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Fax | 469-929-9250
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. TAMARA DAVETTE THOMAS
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Credential | DC
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Telephone | 214-303-7692
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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 |
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License Number State |
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