Individual
DR. JACK L MIKEWORTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
2200 EVANS AVE, FORT WORTH, TX 76104-6066
(817) 926-4693
(817) 920-9625
Mailing address
2009 LEIGHTON DR, ARLINGTON, TX 76015-3228
(817) 557-9523
(866) 807-8992
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
5714
TX
Other
Enumeration date
01/29/2007
Last updated
07/08/2007
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