Provider Demographics
NPI:1083320196
Name:CHIROPRACTIC CONNECTION
Entity Type:Organization
Organization Name:CHIROPRACTIC CONNECTION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:TYLUR
Authorized Official - Middle Name:
Authorized Official - Last Name:ARVIDSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:304-244-4470
Mailing Address - Street 1:5316 YACHT HAVEN GRANDE UNIT 27
Mailing Address - Street 2:
Mailing Address - City:ST THOMAS
Mailing Address - State:VI
Mailing Address - Zip Code:00802-5027
Mailing Address - Country:US
Mailing Address - Phone:340-244-4470
Mailing Address - Fax:
Practice Address - Street 1:5316 YACHT HAVEN GRANDE # 107
Practice Address - Street 2:
Practice Address - City:ST THOMAS
Practice Address - State:VI
Practice Address - Zip Code:00802-5027
Practice Address - Country:US
Practice Address - Phone:678-485-0260
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-24
Last Update Date:2023-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Single Specialty