Provider Demographics
NPI:1578717849
Name:SPORTS & FAMILY CHIROPRACTIC & ACUPUNCTURE, PA
Entity Type:Organization
Organization Name:SPORTS & FAMILY CHIROPRACTIC & ACUPUNCTURE, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:ARNOLD
Authorized Official - Last Name:KILPATRICK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:817-223-3599
Mailing Address - Street 1:203 E OAK ST
Mailing Address - Street 2:
Mailing Address - City:ALEDO
Mailing Address - State:TX
Mailing Address - Zip Code:76008-4345
Mailing Address - Country:US
Mailing Address - Phone:817-223-3599
Mailing Address - Fax:
Practice Address - Street 1:203 E OAK ST
Practice Address - Street 2:
Practice Address - City:ALEDO
Practice Address - State:TX
Practice Address - Zip Code:76008-4345
Practice Address - Country:US
Practice Address - Phone:817-223-3599
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-12
Last Update Date:2008-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center