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Individual

DR. ATHENA MARIE PAYNE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
D.C.

Contact information

Practice address
4255 BRYANT IRVIN RD, SUITE 108, FORT WORTH, TX 76109-4233
(817) 731-4848
(817) 731-4858
Mailing address
4255 BRYANT IRVIN RD, SUITE 108, FORT WORTH, TX 76109-4233
(817) 731-4848
(817) 731-4858

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
11597
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1437483831
MEDICARE GROUP NPI SALANCE CLINIC INC.
TX
01
TXB127631
MEDICARE PTAN GROUP
TX
Enumeration date
03/20/2010
Last updated
04/15/2016
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