Provider Demographics
NPI:1659831923
Name:SOCIETY CHIROPRACTIC COMPANY LLC
Entity Type:Organization
Organization Name:SOCIETY CHIROPRACTIC COMPANY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISITAN
Authorized Official - Middle Name:
Authorized Official - Last Name:POLDRACK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:432-614-0888
Mailing Address - Street 1:3408 N MIDKIFF RD STE 307
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79705-4836
Mailing Address - Country:US
Mailing Address - Phone:432-614-0888
Mailing Address - Fax:
Practice Address - Street 1:3408 N MIDKIFF RD STE 307
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79705-4836
Practice Address - Country:US
Practice Address - Phone:432-614-0888
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-22
Last Update Date:2019-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty