Organization
ELLIS PAIN & PAIN REHABILITATION CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESUS D MARCIAL DC (MANAGING PROVIDER)
(972) 875-8600
Entity
Organization
Contact information
Practice address
2200 W ENNIS AVE, SUITE # A, ENNIS, TX 75119-8054
(972) 875-8600
Mailing address
PO BOX 566455, ATLANTA, GA 31156-6455
(770) 504-5162
Taxonomy
Speciality
Code
Description
License number
State
111NR0400X
Rehabilitation Chiropractor
10136
TX
111NR0400X
Rehabilitation Chiropractor
Primary
9980
TX
Other
Enumeration date
06/30/2016
Last updated
06/30/2016
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