Provider Demographics
NPI:1033735840
Name:PURE FAMILY CHIROPRACTIC, LLC
Entity Type:Organization
Organization Name:PURE FAMILY CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DAILYNN
Authorized Official - Middle Name:
Authorized Official - Last Name:DRISCOLL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:903-213-2017
Mailing Address - Street 1:100 LESLIE ST
Mailing Address - Street 2:
Mailing Address - City:BONHAM
Mailing Address - State:TX
Mailing Address - Zip Code:75418-2429
Mailing Address - Country:US
Mailing Address - Phone:719-342-3106
Mailing Address - Fax:
Practice Address - Street 1:2620 N CENTER ST STE 103
Practice Address - Street 2:
Practice Address - City:BONHAM
Practice Address - State:TX
Practice Address - Zip Code:75418-2125
Practice Address - Country:US
Practice Address - Phone:903-213-2017
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-18
Last Update Date:2020-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty