Provider Demographics
NPI:1588239073
Name:IKONIC INJURY CENTER
Entity Type:Organization
Organization Name:IKONIC INJURY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:TERENCE
Authorized Official - Middle Name:
Authorized Official - Last Name:FLOYD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:972-283-3338
Mailing Address - Street 1:5556 S HAMPTON RD
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75232-2202
Mailing Address - Country:US
Mailing Address - Phone:972-283-3338
Mailing Address - Fax:972-283-3353
Practice Address - Street 1:5556 S HAMPTON RD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75232-2202
Practice Address - Country:US
Practice Address - Phone:972-283-3338
Practice Address - Fax:972-283-3353
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-26
Last Update Date:2021-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation