Organization
CORE ACTIVATED REHAB 2 LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JASON MARENO D.C (PARTNER)
(985) 173-1173
Entity
Organization
Contact information
Practice address
1800 EAST HIGHWAY 114, SUITE 101, SOUTHLAKE, TX 76090
(985) 173-1173
Mailing address
1800 EAST HIGHWAY 114, SUITE 101, SOUTHLAKE, TX 76090
(985) 173-1173
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
11687
TX
Other
Enumeration date
03/14/2012
Last updated
03/14/2012
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