Provider Demographics
NPI:1891025185
Name:PROCK WELLNESS CENTER LLC
Entity Type:Organization
Organization Name:PROCK WELLNESS CENTER LLC
Other - Org Name:SANGER FAMILY CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:CHRISTOPHER
Authorized Official - Last Name:PROCK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:405-612-3247
Mailing Address - Street 1:2730 OAK TREE DR
Mailing Address - Street 2:APT 2506
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75006-2195
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:907 CHAPMAN DR.
Practice Address - Street 2:
Practice Address - City:SANGER
Practice Address - State:TX
Practice Address - Zip Code:76266
Practice Address - Country:US
Practice Address - Phone:405-612-3247
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-08
Last Update Date:2010-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11298111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty