Organization
AQUA HAVEN CHIROPRACTIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JINGER R POTH D.C. (DOCTOR OF CHIROPRACTIC)
(512) 508-0632
Entity
Organization
Contact information
Practice address
107 RANCH ROAD 620 SOUTH, SUITE 105, LAKEWAY, TX 78734-3901
(512) 266-7684
Mailing address
4501 WHISPER TRL, BELTON, TX 76513-9521
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
10344
TX
Other
Enumeration date
02/09/2012
Last updated
02/09/2012
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