Organization · NPI-2

Jay Humphrey Dc PA

Clinic/Center · Rockwall, TX

NPI number1407151897
StatusActive
Last updated in NPPESFeb 4, 2014

Details

NPI
1407151897
Entity type
Organization (NPI-2)
Legal business name
Jay Humphrey Dc PA
Organization subpart
No
Enumeration date
Jan 18, 2011
Last updated
Feb 4, 2014

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261Q00000X Clinic/Center10730TXYes

Other names

  • Rockwall Spine And Sports Medicine (Doing Business As)

Practice location

1160 Horizon Rd
Rockwall, TX 75032-5498

Phone 972-722-8800

Mailing address

1160 Horizon Road
Rockwall, TX 75032

Phone 972-722-8800

Authorized official

Jay Humphrey
Owner
9727228800

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