Provider Demographics
NPI:1689959496
Name:THE CHIROPRACTIC PLACE, P.A.
Entity Type:Organization
Organization Name:THE CHIROPRACTIC PLACE, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:PARKER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:682-214-0408
Mailing Address - Street 1:PO BOX 64
Mailing Address - Street 2:
Mailing Address - City:SANTO
Mailing Address - State:TX
Mailing Address - Zip Code:76472-0064
Mailing Address - Country:US
Mailing Address - Phone:682-214-0408
Mailing Address - Fax:817-441-2811
Practice Address - Street 1:213 OLD ANNETTA RD
Practice Address - Street 2:
Practice Address - City:ALEDO
Practice Address - State:TX
Practice Address - Zip Code:76008-4455
Practice Address - Country:US
Practice Address - Phone:682-214-0408
Practice Address - Fax:817-441-2811
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-13
Last Update Date:2014-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11690111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty