Provider Demographics
NPI:1093198376
Name:ERIN CLEARY LLC
Entity Type:Organization
Organization Name:ERIN CLEARY LLC
Other - Org Name:NEW AGE CHIROPRACTIC HEALTH AND ACUPUNCTURE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:
Authorized Official - Last Name:CLEARY
Authorized Official - Suffix:
Authorized Official - Credentials:DC, MAOM, BS
Authorized Official - Phone:512-993-8949
Mailing Address - Street 1:900 RANCH ROAD 620 S
Mailing Address - Street 2:SUITE C-209
Mailing Address - City:LAKEWAY
Mailing Address - State:TX
Mailing Address - Zip Code:78734-5615
Mailing Address - Country:US
Mailing Address - Phone:512-993-8949
Mailing Address - Fax:
Practice Address - Street 1:900 RANCH ROAD 620 S
Practice Address - Street 2:SUITE C-209
Practice Address - City:LAKEWAY
Practice Address - State:TX
Practice Address - Zip Code:78734-5615
Practice Address - Country:US
Practice Address - Phone:512-993-8949
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-03
Last Update Date:2015-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12893111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty