Provider Demographics
NPI:1356567598
Name:VINING, JEFF ALLEN (DC)
Entity type:Individual
Prefix:DR
First Name:JEFF
Middle Name:ALLEN
Last Name:VINING
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:811 S CENTRAL EXPY
Mailing Address - Street 2:300F
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-7415
Mailing Address - Country:US
Mailing Address - Phone:972-231-8585
Mailing Address - Fax:866-532-7189
Practice Address - Street 1:811 S CENTRAL EXPY
Practice Address - Street 2:300F
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-7415
Practice Address - Country:US
Practice Address - Phone:972-231-8585
Practice Address - Fax:866-532-7189
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2013-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10582111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor