Most Relevant Information
Provider Data
| NPI Number: | 1003367731 |
| Provider Name: | TAMIKIA LATRAY PRUNTY DC |
| Entity Type: | Individual |
| Taxonomy Code: | 111NI0013X |
| Specialty: | Chiropractor |
| License Number: | 13247 |
Most Important Dates
| Enumeration Date: | 10/18/2016 |
| Last Updated: | 12/24/2020 |
Provider Practice Location
1930 E ROSEMEADE PKWY STE 204
CARROLLTON
TX
750072468
Practice Location Phone/Fax
| Phone: | 9723959350 |
| Fax: |
Provider Mailing Location
2022 SHENANDOAH DR
CARROLLTON
TX
750075435
Provider Mailing Phone/Fax
| Phone: | 9722949642 |
| Fax: |