Provider Demographics
NPI:1275132755
Name:KREAMER FAMILY CHIROPRACTIC PLLC
Entity Type:Organization
Organization Name:KREAMER FAMILY CHIROPRACTIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:KREAMER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:817-329-8393
Mailing Address - Street 1:1011 W WALL ST
Mailing Address - Street 2:
Mailing Address - City:GRAPEVINE
Mailing Address - State:TX
Mailing Address - Zip Code:76051-5151
Mailing Address - Country:US
Mailing Address - Phone:817-329-8393
Mailing Address - Fax:817-416-6263
Practice Address - Street 1:1011 W WALL ST
Practice Address - Street 2:
Practice Address - City:GRAPEVINE
Practice Address - State:TX
Practice Address - Zip Code:76051-5151
Practice Address - Country:US
Practice Address - Phone:817-329-8393
Practice Address - Fax:817-416-6263
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-26
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1255799771OtherINDIVIDUAL NPI