Provider Demographics
NPI:1083152789
Name:M2 CHIROPRACTIC, LLC
Entity Type:Organization
Organization Name:M2 CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:MORENO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:972-521-6213
Mailing Address - Street 1:940 RIDGEVIEW DR
Mailing Address - Street 2:STE. 100 BLDG. A
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75013-5402
Mailing Address - Country:US
Mailing Address - Phone:972-521-6213
Mailing Address - Fax:469-519-0324
Practice Address - Street 1:940 RIDGEVIEW DRIVE
Practice Address - Street 2:STE. 100, BLDG. A
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75013-5402
Practice Address - Country:US
Practice Address - Phone:972-521-6213
Practice Address - Fax:469-519-0324
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-02
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13381111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty