MEDICARE: ALLAN BRIAN SPEER LMT

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	172M00000X	Mechanotherapist	MT013084	TX

General Provider Information

NPI Number	:	1851764237
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALLAN BRIAN SPEER LMT

Provider Business Mailing Address
First Line	:	2122 KIDWELL ST
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75214-3913
Country	:	US
Telephone Number	:	214-499-1738
Fax Number	:

Provider Business Practice Location Address
First Line	:	2122 KIDWELL ST
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75214-3913
Country	:	US
Telephone Number	:	214-499-1738
Fax Number	:

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

Provider Enumeration Date	:	11/05/2015
Last Update Date	:	11/05/2015

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Directions to “ ALLAN BRIAN SPEER LMT” Practice Location

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