Provider Demographics
NPI:1861818528
Name:TRI-CITY FAMILY CHIROPRACTIC, LLC
Entity Type:Organization
Organization Name:TRI-CITY FAMILY CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF CHIROPRACTIC
Authorized Official - Prefix:DR
Authorized Official - First Name:KAYLA
Authorized Official - Middle Name:RUTH
Authorized Official - Last Name:GLOVER
Authorized Official - Suffix:
Authorized Official - Credentials:DC, BS
Authorized Official - Phone:979-777-8516
Mailing Address - Street 1:295 SOUTHWEST PLZ
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76016-4455
Mailing Address - Country:US
Mailing Address - Phone:817-987-6229
Mailing Address - Fax:817-754-6639
Practice Address - Street 1:295 SOUTHWEST PLZ
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76016-4455
Practice Address - Country:US
Practice Address - Phone:817-987-6229
Practice Address - Fax:817-754-6639
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-05
Last Update Date:2014-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12308111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty