Main Street Injury Clinic LLC
Chiropractor in Fort Worth, TX. Organization (NPI-2).
NPI number1154099596
StatusActive
Last updated in NPPESAug 31, 2021
Details
- NPI
- 1154099596
- Entity type
- Organization (NPI-2)
- Legal business name
- Main Street Injury Clinic LLC
- Organization subpart
- No
- Enumeration date
- Aug 31, 2021
- Certification date
- Aug 31, 2021
- Last updated
- Aug 31, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 111N00000X | Chiropractor | – | – | Yes |
Practice location
2100 N Main St Ste 105Fort Worth, TX 76164-8572
Phone 817-402-9484 · Fax 214-853-5421
Mailing address
2100 N Main St Ste 105Fort Worth, TX 76164-8572
Phone 817-402-9484 · Fax 214-853-5421
Authorized official
Edwardo Dehoyos
Partner
8174029484
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