Provider Demographics
NPI:1043630072
Name:ACCIDENT & INJURY CHIROPRACTIC
Entity type:Organization
Organization Name:ACCIDENT & INJURY CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:VANIECEA
Authorized Official - Middle Name:L
Authorized Official - Last Name:DUNCAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:972-279-7246
Mailing Address - Street 1:200 WYNNEWOOD VILLAGE
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75224
Mailing Address - Country:US
Mailing Address - Phone:214-946-7246
Mailing Address - Fax:214-946-1351
Practice Address - Street 1:1515 N TOWN EAST BLVD
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75150-4157
Practice Address - Country:US
Practice Address - Phone:972-279-7246
Practice Address - Fax:972-279-0955
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ACCIDENT & INJURY PAIN CENTERS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-04-17
Last Update Date:2014-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12386111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty