Provider Demographics
NPI:1780344606
Name:PARAGON CHIROPRACTIC INC.
Entity type:Organization
Organization Name:PARAGON CHIROPRACTIC INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:IAN
Authorized Official - Middle Name:SETH DAVID
Authorized Official - Last Name:KELLY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:806-337-2084
Mailing Address - Street 1:7201 W I 40 STE 210
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79106-2634
Mailing Address - Country:US
Mailing Address - Phone:806-337-2084
Mailing Address - Fax:806-803-9663
Practice Address - Street 1:7201 W I 40 STE 210
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106-2634
Practice Address - Country:US
Practice Address - Phone:806-337-2084
Practice Address - Fax:806-803-9663
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-20
Last Update Date:2022-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty