Provider Demographics
NPI:1437415320
Name:CHIRO ONE WELLNESS CENTER OF ALLEN PLLC
Entity Type:Organization
Organization Name:CHIRO ONE WELLNESS CENTER OF ALLEN PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:SAM
Authorized Official - Middle Name:
Authorized Official - Last Name:WANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-468-1824
Mailing Address - Street 1:PO BOX 677662
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75267-7662
Mailing Address - Country:US
Mailing Address - Phone:630-320-6400
Mailing Address - Fax:630-320-6489
Practice Address - Street 1:190 E STACY RD
Practice Address - Street 2:SUITE 1614
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75002-8734
Practice Address - Country:US
Practice Address - Phone:972-678-3080
Practice Address - Fax:972-678-3083
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-05
Last Update Date:2012-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty