Organization
VITALITY CHIROPRACTIC AND WELLNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEREMY JAMES LIESVELD D.C.,B.S.N.-R.N.,B.A (CHIROPRACTOR)
(832) 671-8569
Entity
Organization
Contact information
Practice address
1205 MEADOWLARK DR, LITTLE ELM, TX 75068-4653
(832) 671-8569
Mailing address
1205 MEADOWLARK DR, LITTLE ELM, TX 75068-4653
Taxonomy
Speciality
Code
Description
License number
State
273Y00000X
Rehabilitation Hospital Unit
Primary
11339
TX
Other
Enumeration date
01/04/2011
Last updated
01/04/2011
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