Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | 10995 | TX |
NPI | 1063658698 |
---|---|
Provider Name | Dr. Mandy De Ann Boyce |
First Address | Dallas, TX 75287-6780 |
Second Address | Terrell, TX 75160-3223 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/01/2009 |
Last Update Date | 03/01/2009 |