Provider Demographics
NPI:1376982439
Name:SPAIN FAMILY CHIROPRACTIC
Entity Type:Organization
Organization Name:SPAIN FAMILY CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:
Authorized Official - Last Name:SPAIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:806-285-2284
Mailing Address - Street 1:PO BOX 468
Mailing Address - Street 2:
Mailing Address - City:OLTON
Mailing Address - State:TX
Mailing Address - Zip Code:79064-0468
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:210 N. MAIN
Practice Address - Street 2:
Practice Address - City:OLTON
Practice Address - State:TX
Practice Address - Zip Code:79064
Practice Address - Country:US
Practice Address - Phone:806-285-2284
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-21
Last Update Date:2013-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12138111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty