Provider Demographics
NPI:1497121198
Name:VIRTUOSITY SPORTS CHIROPRACTIC & MYOFASCIAL THERAPY, PLLC
Entity Type:Organization
Organization Name:VIRTUOSITY SPORTS CHIROPRACTIC & MYOFASCIAL THERAPY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LINDSAY
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:HOFFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:817-505-3459
Mailing Address - Street 1:10800 DUNHAM RD
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:TX
Mailing Address - Zip Code:76262-6504
Mailing Address - Country:US
Mailing Address - Phone:817-505-3459
Mailing Address - Fax:817-288-0605
Practice Address - Street 1:1834 KELLER PKWY STE 300
Practice Address - Street 2:
Practice Address - City:KELLER
Practice Address - State:TX
Practice Address - Zip Code:76248-3761
Practice Address - Country:US
Practice Address - Phone:817-505-3459
Practice Address - Fax:817-288-0605
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-17
Last Update Date:2015-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12987111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty