Provider Demographics
NPI:1659681815
Name:WORK ACCIDENT CHIROPRACTIC CLINIC, PLLC
Entity Type:Organization
Organization Name:WORK ACCIDENT CHIROPRACTIC CLINIC, PLLC
Other - Org Name:ADJUST CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:BOTEFUHR
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:214-922-8844
Mailing Address - Street 1:P.O. BOX 601636
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75360-1636
Mailing Address - Country:US
Mailing Address - Phone:214-922-8844
Mailing Address - Fax:214-368-5656
Practice Address - Street 1:9041 GARLAND RD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75218-3919
Practice Address - Country:US
Practice Address - Phone:214-922-8844
Practice Address - Fax:214-368-5656
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-20
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDC 8668111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty