Provider Demographics
NPI:1407015720
Name:CHICOINE CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:CHICOINE CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JON
Authorized Official - Middle Name:K
Authorized Official - Last Name:CHICOINE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:512-339-9888
Mailing Address - Street 1:9515 N LAMAR BLVD
Mailing Address - Street 2:SUITE 168
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78753-4188
Mailing Address - Country:US
Mailing Address - Phone:512-339-9888
Mailing Address - Fax:512-339-9888
Practice Address - Street 1:9515 N LAMAR BLVD
Practice Address - Street 2:SUITE 168
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78753-4188
Practice Address - Country:US
Practice Address - Phone:512-339-9888
Practice Address - Fax:512-339-9888
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-02
Last Update Date:2008-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4625111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty