Provider Demographics
NPI:1790038297
Name:DURBIN CHIROPRACTIC & WELLNESS CENTER
Entity Type:Organization
Organization Name:DURBIN CHIROPRACTIC & WELLNESS CENTER
Other - Org Name:DURBIN CHIROPRACTIC & WELLNESS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DOCTOR OF CHIROPRACTOR AND OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MISTY
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:DURBIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:361-991-8887
Mailing Address - Street 1:PO BOX 71236
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78467-1236
Mailing Address - Country:US
Mailing Address - Phone:361-991-8887
Mailing Address - Fax:361-991-8889
Practice Address - Street 1:5022 HOLLY RD
Practice Address - Street 2:SUITE 104
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78411-4761
Practice Address - Country:US
Practice Address - Phone:361-991-8887
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-22
Last Update Date:2012-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10083111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty