Provider Demographics
NPI:1487969069
Name:ARMITAGE, JOHN BRADLEY (DC)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:BRADLEY
Last Name:ARMITAGE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9401 LBJ FWY STE 325
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75243-4663
Mailing Address - Country:US
Mailing Address - Phone:214-575-7771
Mailing Address - Fax:214-575-7772
Practice Address - Street 1:9401 LBJ FWY STE 325
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-4663
Practice Address - Country:US
Practice Address - Phone:214-575-7771
Practice Address - Fax:214-575-7772
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-08
Last Update Date:2015-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11515111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor