Organization
ACC-GEORGETOWN LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRYSTLE MICHELLE RUSSO (ACCESS MANAGER)
(512) 680-6479
Entity
Organization
Contact information
Practice address
3007 DAWN DR STE 101, GEORGETOWN, TX 78628-2864
(512) 863-7000
(512) 231-1087
Mailing address
1905 BANDERA CV, ROUND ROCK, TX 78665-5623
(512) 653-9321
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
Other
Enumeration date
07/10/2018
Last updated
07/12/2023
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