Provider Demographics
NPI:1093192098
Name:CLIFFORD CHIRO, PLLC
Entity Type:Organization
Organization Name:CLIFFORD CHIRO, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROGER
Authorized Official - Middle Name:
Authorized Official - Last Name:CLIFFORD
Authorized Official - Suffix:
Authorized Official - Credentials:DC, DACNB
Authorized Official - Phone:972-934-1660
Mailing Address - Street 1:4222 TRINITY MILLS RD STE 106
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75287-7604
Mailing Address - Country:US
Mailing Address - Phone:972-934-1660
Mailing Address - Fax:972-934-1633
Practice Address - Street 1:4222 TRINITY MILLS RD STE 106
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75287-7604
Practice Address - Country:US
Practice Address - Phone:972-934-1660
Practice Address - Fax:972-934-1633
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-29
Last Update Date:2015-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NN0400XChiropractic ProvidersChiropractorNeurologyGroup - Single Specialty