Provider Demographics
NPI:1346808342
Name:SPADE CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:SPADE CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ARISUKWU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-777-1621
Mailing Address - Street 1:9207 COUNTRY CREEK DR STE 102
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-7745
Mailing Address - Country:US
Mailing Address - Phone:713-777-1621
Mailing Address - Fax:713-777-1734
Practice Address - Street 1:9207 COUNTRY CREEK DR STE 102
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-7745
Practice Address - Country:US
Practice Address - Phone:713-777-1621
Practice Address - Fax:713-777-1734
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-04
Last Update Date:2019-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy