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Organization
KAIKOA LLC
Active
Organization
KAIKOA LLC
Active
Other names
Freeform Chiropractic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JESSE JACOBS D.C. (OWNER)
(214) 636-6906
Entity
Organization
Contact information
Practice address
4525 HERITAGE TRACE PKWY, SUITE 101, FORT WORTH, TX 76244-8908
(817) 431-5100
(817) 887-3008
Mailing address
4525 HERITAGE TRACE PKWY, SUITE 101, FORT WORTH, TX 76244-8908
(817) 431-5100
(817) 887-3008
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
12301
TX
Other
Enumeration date
06/16/2016
Last updated
06/16/2016
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