Provider Demographics
NPI:1114668746
Name:CLAIRTON FAMILY CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:CLAIRTON FAMILY CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HENSS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-281-1400
Mailing Address - Street 1:3848 N TARRANT PKWY STE 130
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76244-5419
Mailing Address - Country:US
Mailing Address - Phone:817-281-1400
Mailing Address - Fax:
Practice Address - Street 1:3848 N TARRANT PKWY STE 130
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76244-5419
Practice Address - Country:US
Practice Address - Phone:817-281-1400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-06
Last Update Date:2022-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1033531876OtherMEDICARE