Provider Demographics
NPI:1063837763
Name:ACHIEVE CHIROPRACTIC CLINIC INCORPORATE
Entity Type:Organization
Organization Name:ACHIEVE CHIROPRACTIC CLINIC INCORPORATE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:JON
Authorized Official - Middle Name:LAWRENCE
Authorized Official - Last Name:BJARNASON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:940-566-8605
Mailing Address - Street 1:1720 WESTMINSTER ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76205-7831
Mailing Address - Country:US
Mailing Address - Phone:940-566-8605
Mailing Address - Fax:
Practice Address - Street 1:1720 WESTMINSTER ST
Practice Address - Street 2:SUITE 100
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76205-7831
Practice Address - Country:US
Practice Address - Phone:940-566-8605
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-04
Last Update Date:2014-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11684111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty