Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | 14342 | TX |
NPI | 1194356394 |
---|---|
Provider Name | Kali Mccormick |
First Address | Aubrey, TX 76227-8256 |
Second Address | Aubrey, TX 76227-8256 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/01/2020 |
Last Update Date | 28/01/2020 |