Provider Demographics
NPI:1922240001
Name:FAMILY CHIROPRACTIC OF DALLAS, PC
Entity Type:Organization
Organization Name:FAMILY CHIROPRACTIC OF DALLAS, PC
Other - Org Name:SPINEWORKS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:G
Authorized Official - Last Name:ALBERT
Authorized Official - Suffix:III
Authorized Official - Credentials:DC
Authorized Official - Phone:570-465-3444
Mailing Address - Street 1:937 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NEW MILFORD
Mailing Address - State:PA
Mailing Address - Zip Code:18834-7431
Mailing Address - Country:US
Mailing Address - Phone:570-465-3444
Mailing Address - Fax:570-465-5400
Practice Address - Street 1:937 MAIN ST
Practice Address - Street 2:
Practice Address - City:NEW MILFORD
Practice Address - State:PA
Practice Address - Zip Code:18834-7431
Practice Address - Country:US
Practice Address - Phone:570-465-3444
Practice Address - Fax:570-465-5400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-03
Last Update Date:2013-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC009867111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty