Provider Demographics
NPI:1023399904
Name:HEALTHY INNOVATIONS CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:HEALTHY INNOVATIONS CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:YEVGENIYA
Authorized Official - Middle Name:
Authorized Official - Last Name:YANAYEVA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:972-724-7247
Mailing Address - Street 1:2221 CROSS TIMBERS RD
Mailing Address - Street 2:SUITE 137
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75028-2616
Mailing Address - Country:US
Mailing Address - Phone:972-724-7247
Mailing Address - Fax:972-724-7248
Practice Address - Street 1:2221 CROSS TIMBERS RD
Practice Address - Street 2:SUITE 137
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75028-2616
Practice Address - Country:US
Practice Address - Phone:972-724-7247
Practice Address - Fax:972-724-7248
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-06
Last Update Date:2011-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11807111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty