Provider Demographics
NPI:1093268328
Name:ANOUK FAMILY CHIROPRACTIC, PLLC
Entity Type:Organization
Organization Name:ANOUK FAMILY CHIROPRACTIC, PLLC
Other - Org Name:WELL WITHIN ROCKWALL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:KNUCKLES
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:972-587-0101
Mailing Address - Street 1:2555 RIDGE RD #150
Mailing Address - Street 2:
Mailing Address - City:ROCKWALL
Mailing Address - State:TX
Mailing Address - Zip Code:75087
Mailing Address - Country:US
Mailing Address - Phone:972-587-0101
Mailing Address - Fax:
Practice Address - Street 1:2555 RIDGE RD #150
Practice Address - Street 2:
Practice Address - City:ROCKWALL
Practice Address - State:TX
Practice Address - Zip Code:75087
Practice Address - Country:US
Practice Address - Phone:972-587-0101
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-03
Last Update Date:2016-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13091111N00000X, 111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
No111NN1001XChiropractic ProvidersChiropractorNutritionGroup - Single Specialty