Organization
ETHOS REGENERATIVE MEDICAL GROUP PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JASON CORY BLACK D.C. (OWNER)
(972) 409-0016
Entity
Organization
Contact information
Practice address
300 E. ROYAL LN, SUITE 110, IRVING, TX 75039
(972) 409-0016
(972) 409-0013
Mailing address
300 E. ROYAL LN, SUITE 110, IRVING, TX 75039
(972) 409-0016
(972) 409-0013
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
8277
TX
Other
Enumeration date
03/06/2008
Last updated
05/20/2019
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