Provider Demographics
NPI:1831397371
Name:SSC CHIROPRACTIC, P.A.
Entity type:Organization
Organization Name:SSC CHIROPRACTIC, P.A.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:TAN VIET
Authorized Official - Last Name:LAI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:972-416-5873
Mailing Address - Street 1:PO BOX 112624
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75011-2624
Mailing Address - Country:US
Mailing Address - Phone:972-416-5873
Mailing Address - Fax:
Practice Address - Street 1:1212 N JOSEY LN
Practice Address - Street 2:SUITE 250
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75006-6140
Practice Address - Country:US
Practice Address - Phone:972-416-5873
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9363261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service