Provider Demographics
NPI:1134412356
Name:WEATHERFORD CHIROPRACTIC HEALTH CENTER PA
Entity type:Organization
Organization Name:WEATHERFORD CHIROPRACTIC HEALTH CENTER PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:MICHELLE-MARIE
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:BS, DC, CCEP
Authorized Official - Phone:817-594-5944
Mailing Address - Street 1:702 EUREKA ST STE B
Mailing Address - Street 2:
Mailing Address - City:WEATHERFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76086-6519
Mailing Address - Country:US
Mailing Address - Phone:817-594-5944
Mailing Address - Fax:817-594-8495
Practice Address - Street 1:702 EUREKA ST STE B
Practice Address - Street 2:
Practice Address - City:WEATHERFORD
Practice Address - State:TX
Practice Address - Zip Code:76086-6519
Practice Address - Country:US
Practice Address - Phone:817-594-5944
Practice Address - Fax:817-594-8495
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-20
Last Update Date:2023-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X
TX8933111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8C7789Medicare PIN