Provider Demographics
NPI:1780220061
Name:CHIROFLEX, LLC
Entity Type:Organization
Organization Name:CHIROFLEX, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:JILL
Authorized Official - Last Name:TEDFORD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:501-743-8307
Mailing Address - Street 1:PO BOX 1046
Mailing Address - Street 2:
Mailing Address - City:BEEBE
Mailing Address - State:AR
Mailing Address - Zip Code:72012-1046
Mailing Address - Country:US
Mailing Address - Phone:501-232-9587
Mailing Address - Fax:855-237-1147
Practice Address - Street 1:131 HWY 64 W
Practice Address - Street 2:
Practice Address - City:BEEBE
Practice Address - State:AR
Practice Address - Zip Code:72012-9506
Practice Address - Country:US
Practice Address - Phone:501-232-9587
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-21
Last Update Date:2019-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty