Provider Demographics
NPI:1235787243
Name:ETS HEALTH & PERFORMANCE, LLC
Entity Type:Organization
Organization Name:ETS HEALTH & PERFORMANCE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MAJORITY OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVIS
Authorized Official - Middle Name:
Authorized Official - Last Name:MCALISTER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:469-688-1418
Mailing Address - Street 1:6022 MYERS CT
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE VILLAGE
Mailing Address - State:TX
Mailing Address - Zip Code:76227-1714
Mailing Address - Country:US
Mailing Address - Phone:469-688-1418
Mailing Address - Fax:
Practice Address - Street 1:9930 US HIGHWAY 380
Practice Address - Street 2:
Practice Address - City:CROSSROADS
Practice Address - State:TX
Practice Address - Zip Code:76227-8228
Practice Address - Country:US
Practice Address - Phone:513-494-0343
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-03
Last Update Date:2019-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Single Specialty