Provider Demographics
NPI:1215169917
Name:PROGRESSIVE CHIROPRACTIC &
Entity type:Organization
Organization Name:PROGRESSIVE CHIROPRACTIC &
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DELMAR
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:BROOKS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:903-938-0050
Mailing Address - Street 1:1203 E PINECREST DR
Mailing Address - Street 2:
Mailing Address - City:MARSHALL
Mailing Address - State:TX
Mailing Address - Zip Code:75670-7355
Mailing Address - Country:US
Mailing Address - Phone:903-938-0050
Mailing Address - Fax:903-938-8081
Practice Address - Street 1:1203 E PINECREST DR
Practice Address - Street 2:
Practice Address - City:MARSHALL
Practice Address - State:TX
Practice Address - Zip Code:75670-7355
Practice Address - Country:US
Practice Address - Phone:903-938-0050
Practice Address - Fax:903-938-8081
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-13
Last Update Date:2012-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center