Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | 13875 | TX |
NPI | 1336603257 |
---|---|
Provider Name | Beverly J Owusu-Duku |
First Address | Grand Prairie, TX 75051-3546 |
Second Address | Grand Prairie, TX 75051-3546 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/01/2019 |
Last Update Date | 24/01/2019 |