Chiro One Wellness Center of South Lake Pllc

NPI #1255600912 in Southlake, Texas

Provider Information

NPI Number: 1255600912
Entity Type: Organization
Organization Name: Chiro One Wellness Center of South Lake Pllc
Primary Specialty: Chiropractor
Enumeration Date: Dec 23, 2011
Last Updated: Nov 9, 2012

Practice Location

Address: 280 COMMERCE ST
Address 2: STE F
City: Southlake
State: Texas
ZIP Code: 76092-9100
Phone: (817) 865-5520

Authorized Official

Name: SAM WANG
Title: COO
Phone: (630) 468-1824

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Chiropractor	111N00000X	Primary

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