Provider Demographics
NPI:1063026870
Name:AUSTIN CHIROPRACTIC AND REHAB LLC
Entity Type:Organization
Organization Name:AUSTIN CHIROPRACTIC AND REHAB LLC
Other - Org Name:WHITEHEAD CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHAWN
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:MCHONE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:512-451-0115
Mailing Address - Street 1:5775 AIRPORT BLVD STE 300
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78752-4214
Mailing Address - Country:US
Mailing Address - Phone:512-643-1642
Mailing Address - Fax:512-451-1208
Practice Address - Street 1:5775 AIRPORT BLVD STE 300
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78752-4214
Practice Address - Country:US
Practice Address - Phone:512-643-1642
Practice Address - Fax:512-451-1208
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-31
Last Update Date:2020-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty