Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 10925 | TX |
N | 111NN0400X | Neurology | 10925 | TX |
NPI | 1346403763 |
---|---|
Provider Name | Dr. Luke Molitor |
First Address | Dallas, TX 75254-3054 |
Second Address | Dallas, TX 75254-3054 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2008 |
Last Update Date | 07/07/2008 |