Provider Demographics
NPI:1184180291
Name:NEUROMUSCULAR CORPORATE SOLUTIONS
Entity Type:Organization
Organization Name:NEUROMUSCULAR CORPORATE SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:DARYL
Authorized Official - Middle Name:
Authorized Official - Last Name:LANEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:817-201-6846
Mailing Address - Street 1:950 EAST HIGHWAY 114
Mailing Address - Street 2:SUITE 160
Mailing Address - City:SOUTHLAKE
Mailing Address - State:TX
Mailing Address - Zip Code:76092
Mailing Address - Country:US
Mailing Address - Phone:817-380-4183
Mailing Address - Fax:
Practice Address - Street 1:950 EAST HIGHWAY 114
Practice Address - Street 2:SUITE 160
Practice Address - City:SOUTHLAKE
Practice Address - State:TX
Practice Address - Zip Code:76092
Practice Address - Country:US
Practice Address - Phone:817-380-4183
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-13
Last Update Date:2019-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty