Individual
TANKISO KATLEHO MOCHACHE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DC
Contact information
Practice address
2922 ALOUETTE DR, GRAND PRAIRIE, TX 75052-8136
(972) 955-4134
(817) 633-4464
Mailing address
2922 ALOUETTE DR, GRAND PRAIRIE, TX 75052-8136
(972) 955-4134
(817) 633-4464
Taxonomy
Speciality
Code
Description
License number
State
111NR0400X
Rehabilitation Chiropractor
Primary
12064
TX
Other
Enumeration date
09/11/2012
Last updated
07/17/2013
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