MEDICARE: BURNS RIVER RIDGE CHIROPRACTIC

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

General Provider Information

NPI Number	:	1679352439
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BURNS RIVER RIDGE CHIROPRACTIC

Provider Business Mailing Address
First Line	:	127 QUITMAN ST
Second Line	:
City	:	PITTSBURG
State	:	TX
Zip	:	75686-1359
Country	:	US
Telephone Number	:	903-423-6370
Fax Number	:

Provider Business Practice Location Address
First Line	:	127 QUITMAN ST
Second Line	:
City	:	PITTSBURG
State	:	TX
Zip	:	75686-1359
Country	:	US
Telephone Number	:	903-423-6370
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JEFFREY BURNS
Credential	:	DC
Telephone Number	:	903-423-6370

Provider Enumeration Date	:	09/21/2023
Last Update Date	:	09/21/2023

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Directions to “BURNS RIVER RIDGE CHIROPRACTIC ” Practice Location

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