Provider Demographics
NPI:1134501802
Name:LJ3 HOLDINGS, LLC
Entity Type:Organization
Organization Name:LJ3 HOLDINGS, LLC
Other - Org Name:STACK VELOCITY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:COX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:580-763-7336
Mailing Address - Street 1:1800 EAST STATE HIGHWAY 114
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SOUTHLAKE
Mailing Address - State:TX
Mailing Address - Zip Code:76092-6529
Mailing Address - Country:US
Mailing Address - Phone:817-416-0606
Mailing Address - Fax:817-488-7972
Practice Address - Street 1:1800 EAST STATE HIGHWAY 114
Practice Address - Street 2:SUITE 101
Practice Address - City:SOUTHLAKE
Practice Address - State:TX
Practice Address - Zip Code:76092-6529
Practice Address - Country:US
Practice Address - Phone:817-416-0606
Practice Address - Fax:817-488-7972
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-18
Last Update Date:2015-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty