Organization
CORE ACTIVATED REHAB L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JASON CHARLES MARENO D.C. (MANAGING MEMBER/OWNER)
(985) 713-1173
Entity
Organization
Contact information
Practice address
801 HAMMOND ST. SUITE 100, COPPELL, TX 75019
(985) 713-1173
Mailing address
801 HAMMOND ST. SUITE 100, COPPELL, TX 75019
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
11687
TX
Other
Enumeration date
03/14/2011
Last updated
03/14/2011
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