Organization
ACTIVE HEALTH CENTER, PC
Active
Organization
ACTIVE HEALTH CENTER, PC
Active
Other names
Community Chiropractic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEVIN HANDCOCK D.C. (PRESIDENT/OWNER)
(512) 310-2747
Entity
Organization
Contact information
Practice address
1713 S MAYS ST STE A, ROUND ROCK, TX 78664-6738
(512) 310-2747
(512) 310-2759
Mailing address
1713 S MAYS ST STE A, ROUND ROCK, TX 78664-6738
(512) 310-2747
(512) 310-2759
Taxonomy
Speciality
Code
Description
License number
State
111NR0400X
Rehabilitation Chiropractor
Primary
5351
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0A4990
MEDICARE GROUP PTAN
TX
05
—
C06035727
—
TX
Enumeration date
01/16/2009
Last updated
09/30/2009
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