Provider Demographics
NPI:1588609911
Name:TROWBRIDGE CHIROPRACTIC CENTER
Entity Type:Organization
Organization Name:TROWBRIDGE CHIROPRACTIC CENTER
Other - Org Name:TROWBRIDGE CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:D.C./OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BEN
Authorized Official - Middle Name:C
Authorized Official - Last Name:TROWBRIDGE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:325-942-7661
Mailing Address - Street 1:2112 W BEAUREGARD AVE
Mailing Address - Street 2:
Mailing Address - City:SAN ANGELO
Mailing Address - State:TX
Mailing Address - Zip Code:76901-3815
Mailing Address - Country:US
Mailing Address - Phone:325-942-7661
Mailing Address - Fax:325-942-0116
Practice Address - Street 1:2112 W BEAUREGARD AVE
Practice Address - Street 2:
Practice Address - City:SAN ANGELO
Practice Address - State:TX
Practice Address - Zip Code:76901-3815
Practice Address - Country:US
Practice Address - Phone:325-942-7661
Practice Address - Fax:325-942-0116
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2944111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0083JFOtherBLUE CROSS
TX0083JFOtherBLUE CROSS