Provider Demographics
NPI:1073098265
Name:V.I.P. CHIROPRACTIC CARE, PLLC
Entity Type:Organization
Organization Name:V.I.P. CHIROPRACTIC CARE, PLLC
Other - Org Name:V.I.P. CHIROPRACTIC CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GLEN
Authorized Official - Middle Name:
Authorized Official - Last Name:WILKINSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:512-809-1113
Mailing Address - Street 1:3115 S 1ST ST APT 101
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78704-6357
Mailing Address - Country:US
Mailing Address - Phone:512-809-1113
Mailing Address - Fax:512-895-9892
Practice Address - Street 1:3115 S 1ST ST APT 101
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78704-6357
Practice Address - Country:US
Practice Address - Phone:512-819-1113
Practice Address - Fax:512-641-8044
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-03
Last Update Date:2023-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty