Provider Demographics
NPI:1114287307
Name:CHIROHEALTH REHAB
Entity Type:Organization
Organization Name:CHIROHEALTH REHAB
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TRACEY
Authorized Official - Middle Name:STONE
Authorized Official - Last Name:MCINTYRE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:281-993-9333
Mailing Address - Street 1:1819 BROADWAY ST STE 101
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77581-5671
Mailing Address - Country:US
Mailing Address - Phone:281-993-9333
Mailing Address - Fax:281-993-0634
Practice Address - Street 1:1819 BROADWAY ST STE 101
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77581-5671
Practice Address - Country:US
Practice Address - Phone:281-993-9333
Practice Address - Fax:281-993-0634
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-21
Last Update Date:2012-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9989111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Multi-Specialty