MEDICARE: INJURY & PAIN CHIROPRACTIC CLINIC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261Q00000X	Clinic/Center	5221	TX

General Provider Information

NPI Number	:	1013183748
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INJURY & PAIN CHIROPRACTIC CLINIC

Provider Business Mailing Address
First Line	:	115 E COLORADO BLVD
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75203-1209
Country	:	US
Telephone Number	:	214-948-1849
Fax Number	:	214-943-8465

Provider Business Practice Location Address
First Line	:	115 E COLORADO BLVD
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75203-1209
Country	:	US
Telephone Number	:	214-948-1849
Fax Number	:	214-943-8465

Authorized Official
Title or Position	:	OWNER
Name	:	DR. KARIM AMIRGHOLIZADEH
Credential	:	D.C.
Telephone Number	:	214-948-1849

Provider Enumeration Date	:	05/02/2008
Last Update Date	:	05/02/2008

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