Provider Demographics
NPI:1629424288
Name:C1C2 PLLC
Entity Type:Organization
Organization Name:C1C2 PLLC
Other - Org Name:ATLAS CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:P
Authorized Official - Last Name:SEIVERT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:512-352-1300
Mailing Address - Street 1:1426 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:TAYLOR
Mailing Address - State:TX
Mailing Address - Zip Code:76574-3032
Mailing Address - Country:US
Mailing Address - Phone:512-352-1300
Mailing Address - Fax:512-352-1301
Practice Address - Street 1:1426 N MAIN ST
Practice Address - Street 2:
Practice Address - City:TAYLOR
Practice Address - State:TX
Practice Address - Zip Code:76574-3032
Practice Address - Country:US
Practice Address - Phone:512-352-1300
Practice Address - Fax:512-352-1301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-12
Last Update Date:2016-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10908111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty