Provider Demographics
NPI:1639463128
Name:SQUYRES INVESTMENTS LLC
Entity Type:Organization
Organization Name:SQUYRES INVESTMENTS LLC
Other - Org Name:JUSTIN FAMILY CHIROPRACTIC & REHAB
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DOCTOR OF CHIROPRACTIC
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:CODY
Authorized Official - Last Name:SQUYERS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:940-441-9285
Mailing Address - Street 1:204 N JACKSON AVE
Mailing Address - Street 2:
Mailing Address - City:JUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:76247-9582
Mailing Address - Country:US
Mailing Address - Phone:940-441-9285
Mailing Address - Fax:940-538-5393
Practice Address - Street 1:204 N JACKSON AVE
Practice Address - Street 2:
Practice Address - City:JUSTIN
Practice Address - State:TX
Practice Address - Zip Code:76247-9582
Practice Address - Country:US
Practice Address - Phone:940-441-9285
Practice Address - Fax:940-538-5393
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-02
Last Update Date:2014-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB128311Medicare PIN