Organization
620 CHIROPRACTIC & LONGEVITY CENTER, PLLC
Active
Other names
620 Chiropractic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICAH WYNN PITTMAN DC (OWNER)
(425) 457-1980
Entity
Organization
Contact information
Practice address
1603 RANCH ROAD 620 N STE 200, LAKEWAY, TX 78734-2324
(512) 266-8100
(512) 266-8103
Mailing address
1603 RANCH ROAD 620 N STE 200, LAKEWAY, TX 78734-2324
(512) 266-8100
(512) 266-8103
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
13544
TX
Other
Enumeration date
08/31/2017
Last updated
07/21/2022
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