Provider Demographics
NPI:1104989441
Name:FAMILY FIRST CHIROPRACTIC WELLNESS CENTER
Entity type:Organization
Organization Name:FAMILY FIRST CHIROPRACTIC WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:W
Authorized Official - Last Name:LYNCH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:817-579-5482
Mailing Address - Street 1:1804 ACTON HWY
Mailing Address - Street 2:
Mailing Address - City:GRANBURY
Mailing Address - State:TX
Mailing Address - Zip Code:76049-5900
Mailing Address - Country:US
Mailing Address - Phone:817-579-5482
Mailing Address - Fax:817-579-5483
Practice Address - Street 1:1804 ACTON HWY
Practice Address - Street 2:
Practice Address - City:GRANBURY
Practice Address - State:TX
Practice Address - Zip Code:76049-5900
Practice Address - Country:US
Practice Address - Phone:817-579-5482
Practice Address - Fax:817-579-5483
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9808111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXV04288Medicare UPIN
TX8D4075Medicare ID - Type Unspecified