MEDICARE: RESTORATION DALLAS CHIROPRACTIC PLLC

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	12587	TX

General Provider Information

NPI Number	:	1679961155
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RESTORATION DALLAS CHIROPRACTIC PLLC

Provider Business Mailing Address
First Line	:	1152 N BUCKNER BLVD STE H100B
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75218-3483
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1152 N BUCKNER BLVD STE H100B
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75218-3483
Country	:	US
Telephone Number	:	678-435-6466
Fax Number	:

Authorized Official
Title or Position	:	CHIROPRACTOR/OWNER
Name	:	DR. JULIA MEIER MILLER
Credential	:
Telephone Number	:	678-435-6466

Provider Enumeration Date	:	01/06/2015
Last Update Date	:	10/26/2015

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