Provider Demographics
NPI:1679670368
Name:COIT CHIROPRACTIC & PHYSICAL THERAPY PA
Entity Type:Organization
Organization Name:COIT CHIROPRACTIC & PHYSICAL THERAPY PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DC
Authorized Official - Prefix:DR
Authorized Official - First Name:FARROKH
Authorized Official - Middle Name:
Authorized Official - Last Name:SHARAFPOUR
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:972-503-2273
Mailing Address - Street 1:5414 FOREST LN
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75244-8008
Mailing Address - Country:US
Mailing Address - Phone:972-503-2273
Mailing Address - Fax:972-503-0336
Practice Address - Street 1:5414 FOREST LN
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75244-8008
Practice Address - Country:US
Practice Address - Phone:972-503-2273
Practice Address - Fax:972-503-0336
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-17
Last Update Date:2012-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7222111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty