Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 11752 | TX |
N | 111NX0800X | Chiropractor Orthopedic Specialist | 11752 | TX |
NPI | 1285070086 |
---|---|
Provider Name | Dr. Michael Romine |
First Address | Dallas, TX 75220-5869 |
Second Address | Bedford, TX 76021-6607 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/05/2013 |
Last Update Date | 20/05/2013 |