Odom Chiropractic Clinic
Clinic/Center, Medical Specialty in Fort Worth, TX. Organization (NPI-2).
NPI number1619115995
StatusActive
Last updated in NPPESJan 26, 2009
Details
- NPI
- 1619115995
- Entity type
- Organization (NPI-2)
- Legal business name
- Odom Chiropractic Clinic
- Organization subpart
- No
- Enumeration date
- Jan 26, 2009
- Last updated
- Jan 26, 2009
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QM2500X | Clinic/Center, Medical Specialty | DC5994 | TX | Yes |
Practice location
6125 Interstate 20302
Fort Worth, TX 76132-3629
Phone 817-738-9777 · Fax 817-738-8708
Mailing address
6125 Interstate 20302
Fort Worth, TX 76132-3629
Phone 817-738-9777 · Fax 817-738-8708
Authorized official
Timothy E Odom
Owner
8177389777
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