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Organization
KILLEEN INJURY CLINIC, INC.
Active
Organization
KILLEEN INJURY CLINIC, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NAT MANGUM (CEO)
(469) 688-6628
Entity
Organization
Contact information
Practice address
100 E CENTRAL TEXAS EXPY, SUITE 100, KILLEEN, TX 76541-8525
(254) 501-3555
(254) 501-3554
Mailing address
5931 DESCO DRIVE, DALLAS, TX 75225
(214) 692-6666
(214) 692-6670
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
14136
TX
208D00000X
General Practice Physician
J1957
TX
225100000X
Physical Therapist
Primary
1030278
TX
Other
Enumeration date
06/28/2007
Last updated
04/22/2009
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