Organization
ADVANCED WELLNESS AND REHAB CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS CORINNA CARLA JUMAO-AS OT (OFFICE MANAGER)
(972) 392-7008
Entity
Organization
Contact information
Practice address
6029 BELT LINE RD STE 100, DALLAS, TX 75254-9137
(972) 392-7008
(972) 392-1171
Mailing address
6029 BELT LINE RD STE 100, DALLAS, TX 75254-9137
(972) 392-7008
(972) 392-1171
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
DC4635
TX
171100000X
Acupuncturist
DC4635
TX
225100000X
Physical Therapist
DC4635
TX
225X00000X
Occupational Therapist
Primary
111489
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0034KD
BLUE CROSS BLUE SHIELD GR
TX
01
—
8J3270
BLUE CROSS BLUE SHIELD
TX
01
—
8T4335
BLUECROSS BLUE SHIELD
TX
Enumeration date
08/22/2006
Last updated
09/11/2025
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