Provider Demographics
NPI:1033177738
Name:MBOS CHIROPRACTIC CLINIC
Entity Type:Organization
Organization Name:MBOS CHIROPRACTIC CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BOYOUNG
Authorized Official - Middle Name:
Authorized Official - Last Name:CHUNG
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:832-466-6656
Mailing Address - Street 1:1519 FLORENCE RD
Mailing Address - Street 2:STE4
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76541-7979
Mailing Address - Country:US
Mailing Address - Phone:254-634-4010
Mailing Address - Fax:254-634-4010
Practice Address - Street 1:1519 FLORENCE RD
Practice Address - Street 2:STE4
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76541-7979
Practice Address - Country:US
Practice Address - Phone:254-634-4010
Practice Address - Fax:254-634-4010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-02
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF007301261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center