NPI 1588070528 · live from the CMS NPI Registry
1p410 Sports Performance
Chiropractor, Sports Physician in The Woodlands, TX. National Provider Identifier 1588070528, active.
NPI record
| NPI | 1588070528 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Chiropractor, Sports Physician 111NS0005X |
| Practice location | 7 Player Grove Ct, The Woodlands, TX 77382 |
| Practice phone | 832-791-5954 |
| Enumerated | July 10, 2014 |
| Last updated | July 10, 2014 |
| Authorized official | Derrick Raymer, Director Of Sports Performance |
| Other names | Athletic Republic-The Woodlands |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Chiropractor, Sports Physician primary | 111NS0005X | 12247 (TX) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.