Provider Demographics
NPI:1194944306
Name:CHAMPION FAMILY CHIROPRACTIC, LLC
Entity type:Organization
Organization Name:CHAMPION FAMILY CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:SINH
Authorized Official - Last Name:TRAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:832-656-0843
Mailing Address - Street 1:205 CHAMPION WAY
Mailing Address - Street 2:(SUITE #8)
Mailing Address - City:GEORGETOWN
Mailing Address - State:KY
Mailing Address - Zip Code:40324-8862
Mailing Address - Country:US
Mailing Address - Phone:832-656-0843
Mailing Address - Fax:502-867-7428
Practice Address - Street 1:205 CHAMPION WAY
Practice Address - Street 2:(SUITE #8)
Practice Address - City:GEORGETOWN
Practice Address - State:KY
Practice Address - Zip Code:40324-8862
Practice Address - Country:US
Practice Address - Phone:832-656-0843
Practice Address - Fax:502-867-7428
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY5029111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty