Michael Clarkson, | |
6223 Bordeaux Ave Apt 104, Dallas, TX 75209-5774 | |
(512) 736-4737 | |
Not Available |
Full Name | Michael Clarkson |
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Gender | Male |
Speciality | Chiropractor |
Location | 6223 Bordeaux Ave Apt 104, Dallas, Texas |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1922667666 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111N00000X | Chiropractor | 14141 (Texas) | Primary |
Provider Name | Comprehensive Injury Treatment Services Pllc |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1811325954 PECOS PAC ID: 6406086032 Enrollment ID: O20140227001395 |
Mailing Address | Practice Location Address |
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Michael Clarkson, 6223 Bordeaux Ave Apt 104, Dallas, TX 75209-5774 Ph: (512) 736-4737 | Michael Clarkson, 6223 Bordeaux Ave Apt 104, Dallas, TX 75209-5774 Ph: (512) 736-4737 |
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