Provider Demographics
NPI:1669018560
Name:LIGHT MATTERS, LLC
Entity Type:Organization
Organization Name:LIGHT MATTERS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JUDITH-ANN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:KNOWLES
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:817-905-4369
Mailing Address - Street 1:4400 W UNIVERSITY BLVD APT 17206
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75209-3702
Mailing Address - Country:US
Mailing Address - Phone:817-905-4369
Mailing Address - Fax:972-645-2175
Practice Address - Street 1:4400 W UNIVERSITY BLVD APT 17206
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75209-3702
Practice Address - Country:US
Practice Address - Phone:817-905-4369
Practice Address - Fax:972-645-2175
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-26
Last Update Date:2019-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty