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NPI Code Detail

MEDICARE: DURRUM CHIROPRACTIC CLINIC LLC

MEDICARE: DURRUM CHIROPRACTIC CLINIC LLC
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
1111N00000XChiropractor8436TX

General Provider Information

NPI Number : 1891115069
Entity Type Code : Organization
Provider Name (Legal Business Name) : DURRUM CHIROPRACTIC CLINIC LLC
Provider Business Mailing Address
First Line : 1011 N JEFFERSON AVE
Second Line :
City : MOUNT PLEASANT
State : TX
Zip : 75455-3261
Country : US
Telephone Number : 903-572-1128
Fax Number : 903-572-1138
Provider Business Practice Location Address
First Line : 1011 N JEFFERSON AVE
Second Line :
City : MOUNT PLEASANT
State : TX
Zip : 75455-3261
Country : US
Telephone Number : 903-572-1128
Fax Number : 903-572-1138
Authorized Official
Title or Position : DR./OWNER
Name : DR. COURTNEY MICHELLE DURRUM
Credential : D.C.
Telephone Number : 903-572-1128
Provider Enumeration Date : 04/25/2014
Last Update Date : 04/25/2014

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Directions to “DURRUM CHIROPRACTIC CLINIC LLC ” Practice Location

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