Provider Demographics
NPI:1841307121
Name:CHIROMASSAGE CHIROPRACTIC CENTER
Entity type:Organization
Organization Name:CHIROMASSAGE CHIROPRACTIC CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:J
Authorized Official - Last Name:BLAHA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:214-219-3260
Mailing Address - Street 1:3626 N HALL ST STE 600
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75219-5126
Mailing Address - Country:US
Mailing Address - Phone:214-219-3260
Mailing Address - Fax:
Practice Address - Street 1:3626 N HALL ST STE 600
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75219-5126
Practice Address - Country:US
Practice Address - Phone:214-219-3260
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-24
Last Update Date:2014-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8792111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty