Provider Demographics
NPI:1821714874
Name:BLUE MONKEY CHIROPRACTIC AND WELLNESS
Entity Type:Organization
Organization Name:BLUE MONKEY CHIROPRACTIC AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HILLARY
Authorized Official - Middle Name:
Authorized Official - Last Name:BAKER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:512-508-4009
Mailing Address - Street 1:1611 WILLIAMS DR STE 2
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:TX
Mailing Address - Zip Code:78628-3659
Mailing Address - Country:US
Mailing Address - Phone:512-508-4009
Mailing Address - Fax:
Practice Address - Street 1:1611 WILLIAMS DR STE 2
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:TX
Practice Address - Zip Code:78628-3659
Practice Address - Country:US
Practice Address - Phone:512-508-4009
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-12
Last Update Date:2022-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty