Provider Demographics
NPI:1629377122
Name:REILAND CHIROPRACTIC AND HEALING INSTITUTE
Entity Type:Organization
Organization Name:REILAND CHIROPRACTIC AND HEALING INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DOCTOC OF CHIROPRACTIC
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:ELMER
Authorized Official - Last Name:REILAND
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:817-905-5009
Mailing Address - Street 1:1100 S MAIN ST
Mailing Address - Street 2:STE. D
Mailing Address - City:GRAPEVINE
Mailing Address - State:TX
Mailing Address - Zip Code:76051-7531
Mailing Address - Country:US
Mailing Address - Phone:817-905-5009
Mailing Address - Fax:817-488-9054
Practice Address - Street 1:1100 S MAIN ST
Practice Address - Street 2:STE. D
Practice Address - City:GRAPEVINE
Practice Address - State:TX
Practice Address - Zip Code:76051-7531
Practice Address - Country:US
Practice Address - Phone:817-905-5009
Practice Address - Fax:817-488-9054
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-23
Last Update Date:2012-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11491111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty