Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 10706 | TX |
N | 111NR0400X | Rehabilitation Chiropractor | 10706 | TX |
N | 111NS0005X | Chiropractic Sports Physician | 10706 | TX |
NPI | 1134224330 |
---|---|
Provider Name | Dr. Robert M Ackerman |
First Address | Dallas, TX 75229-3006 |
Second Address | Plano, TX 75023-4224 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/09/2006 |
Last Update Date | 27/10/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
V04533 | (02) | IL |