MEDICARE: SPECTRUM CHIROPRACTIC & ACUPUNCTURE

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	10054	TX

General Provider Information

NPI Number	:	1891015699
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SPECTRUM CHIROPRACTIC & ACUPUNCTURE

Provider Business Mailing Address
First Line	:	3906 LEMMON AVE
Second Line	:	SUITE 214
City	:	DALLAS
State	:	TX
Zip	:	75219-3734
Country	:	US
Telephone Number	:	214-520-0092
Fax Number	:	214-520-0092

Provider Business Practice Location Address
First Line	:	3906 LEMMON AVE
Second Line	:	SUITE 214
City	:	DALLAS
State	:	TX
Zip	:	75219-3734
Country	:	US
Telephone Number	:	214-520-0092
Fax Number	:	214-520-0092

Authorized Official
Title or Position	:	DOCTOR
Name	:	DR. KARIM HARATIZADEH
Credential	:	D.C.
Telephone Number	:	214-520-0092

Provider Enumeration Date	:	06/03/2010
Last Update Date	:	06/03/2010

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