MEDICARE: DR. JESSICA CAROL MOHRBECK DC

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	111N00000X	Chiropractor	12613	TX

General Provider Information

NPI Number	:	1396237814
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JESSICA CAROL MOHRBECK DC

Provider Business Mailing Address
First Line	:	3305 LONG PRAIRIE RD STE 120
Second Line	:
City	:	FLOWER MOUND
State	:	TX
Zip	:	75022-2775
Country	:	US
Telephone Number	:	214-436-0827
Fax Number	:

Provider Business Practice Location Address
First Line	:	3305 LONG PRAIRIE RD STE 120
Second Line	:
City	:	FLOWER MOUND
State	:	TX
Zip	:	75022-2775
Country	:	US
Telephone Number	:	214-436-0827
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/31/2018
Last Update Date	:	05/31/2018

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