Provider Demographics
NPI:1558487314
Name:CERNOSEK CHIROPRACTIC. P.C.
Entity Type:Organization
Organization Name:CERNOSEK CHIROPRACTIC. P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:ERIC
Authorized Official - Last Name:CERNOSEK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:254-772-6579
Mailing Address - Street 1:1411 N VALLEY MILLS DR
Mailing Address - Street 2:SUITE H
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76710-4460
Mailing Address - Country:US
Mailing Address - Phone:254-772-6579
Mailing Address - Fax:254-772-6584
Practice Address - Street 1:1411 N VALLEY MILLS DR
Practice Address - Street 2:SUITE H
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76710-4460
Practice Address - Country:US
Practice Address - Phone:254-772-6579
Practice Address - Fax:254-772-6584
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7394111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty