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NPI Code Detail

MEDICARE: ILLUMIN8 CHIROPRACTIC EAST DALLAS

MEDICARE: ILLUMIN8 CHIROPRACTIC EAST DALLAS
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
1111N00000XChiropractor

General Provider Information

NPI Number : 1528703576
Entity Type Code : Organization
Provider Name (Legal Business Name) : ILLUMIN8 CHIROPRACTIC EAST DALLAS
Provider Business Mailing Address
First Line : 4100 SWISS AVE
Second Line :
City : DALLAS
State : TX
Zip : 75204-6661
Country : US
Telephone Number : 469-625-1502
Fax Number :
Provider Business Practice Location Address
First Line : 4100 SWISS AVE
Second Line :
City : DALLAS
State : TX
Zip : 75204-6661
Country : US
Telephone Number : 469-625-1502
Fax Number :
Authorized Official
Title or Position : CLINIC DIRECTOR
Name : DR. NICOLE RIVERA MORALES
Credential : DC
Telephone Number : 469-625-1502
Provider Enumeration Date : 05/04/2022
Last Update Date : 05/04/2022

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Directions to “ILLUMIN8 CHIROPRACTIC EAST DALLAS ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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