Provider Demographics
NPI:1932690104
Name:CUTTING EDGE CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:CUTTING EDGE CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:LINNE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:817-995-6856
Mailing Address - Street 1:4011 ALFORD ST
Mailing Address - Street 2:
Mailing Address - City:COLLEGE STATION
Mailing Address - State:TX
Mailing Address - Zip Code:77845-2051
Mailing Address - Country:US
Mailing Address - Phone:817-995-6856
Mailing Address - Fax:
Practice Address - Street 1:3001 WILDFLOWER DR STE 601
Practice Address - Street 2:
Practice Address - City:BRYAN
Practice Address - State:TX
Practice Address - Zip Code:77802-3061
Practice Address - Country:US
Practice Address - Phone:979-557-0995
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-23
Last Update Date:2018-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty