Provider Demographics
NPI:1912682782
Name:SURPASS CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:SURPASS CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LANDON
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:HUBER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:817-505-8188
Mailing Address - Street 1:122 MILL XING E
Mailing Address - Street 2:
Mailing Address - City:COLLEYVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:76034-3662
Mailing Address - Country:US
Mailing Address - Phone:817-505-8188
Mailing Address - Fax:
Practice Address - Street 1:7167 COLLEYVILLE BLVD STE 103
Practice Address - Street 2:
Practice Address - City:COLLEYVILLE
Practice Address - State:TX
Practice Address - Zip Code:76034-8002
Practice Address - Country:US
Practice Address - Phone:817-505-8188
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-20
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NP0017XChiropractic ProvidersChiropractorPediatric ChiropractorGroup - Single Specialty