Provider Demographics
NPI:1427553130
Name:CHIROATHLETICS PLLC
Entity Type:Organization
Organization Name:CHIROATHLETICS PLLC
Other - Org Name:KC CORE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:Y
Authorized Official - Last Name:CHANG
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:413-717-0475
Mailing Address - Street 1:301 VALLEY COVE DR
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75043-2954
Mailing Address - Country:US
Mailing Address - Phone:413-717-0475
Mailing Address - Fax:855-644-7364
Practice Address - Street 1:4401 COIT RD STE 403
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75035-0516
Practice Address - Country:US
Practice Address - Phone:214-295-4321
Practice Address - Fax:855-644-7364
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-26
Last Update Date:2018-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty