Individual
JERRYLEE OTIMEYE EJUWA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C
Contact information
Practice address
1025 S MAIN ST STE 305, GRAPEVINE, TX 76051-7506
(817) 251-0550
(817) 251-0599
Mailing address
1025 S MAIN ST STE 305, GRAPEVINE, TX 76051-7506
(817) 251-0550
(817) 251-0599
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
11959
TX
Other
Enumeration date
02/06/2012
Last updated
06/30/2020
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