Provider Demographics
NPI:1811476369
Name:RESTORATION CHIROPRACTIC COMPANY LLC
Entity type:Organization
Organization Name:RESTORATION CHIROPRACTIC COMPANY LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JACOB
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHUMANN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:972-818-5820
Mailing Address - Street 1:1061 N COLEMAN ST STE 130
Mailing Address - Street 2:
Mailing Address - City:PROSPER
Mailing Address - State:TX
Mailing Address - Zip Code:75078-2317
Mailing Address - Country:US
Mailing Address - Phone:972-818-5820
Mailing Address - Fax:
Practice Address - Street 1:1061 N COLEMAN ST STE 130
Practice Address - Street 2:
Practice Address - City:PROSPER
Practice Address - State:TX
Practice Address - Zip Code:75078-2317
Practice Address - Country:US
Practice Address - Phone:972-818-5820
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-07
Last Update Date:2018-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty