Provider Demographics
NPI:1669081923
Name:SOUTHERN HILLS CHIROPRACTIC
Entity type:Organization
Organization Name:SOUTHERN HILLS CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:CODY
Authorized Official - Middle Name:
Authorized Official - Last Name:ELENZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:254-258-2995
Mailing Address - Street 1:4741 FM 2313
Mailing Address - Street 2:
Mailing Address - City:KEMPNER
Mailing Address - State:TX
Mailing Address - Zip Code:76539-8724
Mailing Address - Country:US
Mailing Address - Phone:254-258-2295
Mailing Address - Fax:
Practice Address - Street 1:1856 PATRIOT CIR
Practice Address - Street 2:
Practice Address - City:COPPERAS COVE
Practice Address - State:TX
Practice Address - Zip Code:76522
Practice Address - Country:US
Practice Address - Phone:254-258-2295
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-23
Last Update Date:2020-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty