Provider Demographics
NPI:1215663471
Name:ABSOLUTE NATURAL HEALTH CENTER LLC
Entity type:Organization
Organization Name:ABSOLUTE NATURAL HEALTH CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:AL
Authorized Official - Middle Name:
Authorized Official - Last Name:BERRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-676-1281
Mailing Address - Street 1:2700 W PECAN ST STE 204
Mailing Address - Street 2:
Mailing Address - City:PFLUGERVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78660-3070
Mailing Address - Country:US
Mailing Address - Phone:818-535-7335
Mailing Address - Fax:
Practice Address - Street 1:2700 W PECAN ST STE 204
Practice Address - Street 2:
Practice Address - City:PFLUGERVILLE
Practice Address - State:TX
Practice Address - Zip Code:78660-3070
Practice Address - Country:US
Practice Address - Phone:818-535-7335
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-28
Last Update Date:2022-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty