Provider Demographics
NPI:1477948867
Name:LEVELLAND CHIROPRACTIC LLC
Entity type:Organization
Organization Name:LEVELLAND CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER-PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:GREG
Authorized Official - Middle Name:
Authorized Official - Last Name:MARIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:806-894-7000
Mailing Address - Street 1:1003 COLLEGE AVE
Mailing Address - Street 2:
Mailing Address - City:LEVELLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79336-5601
Mailing Address - Country:US
Mailing Address - Phone:806-894-7000
Mailing Address - Fax:806-894-1670
Practice Address - Street 1:1003 COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:LEVELLAND
Practice Address - State:TX
Practice Address - Zip Code:79336-5601
Practice Address - Country:US
Practice Address - Phone:806-894-7000
Practice Address - Fax:806-894-1670
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-01
Last Update Date:2015-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty