Provider Demographics
NPI:1285318766
Name:SPINE TIME CHIROPRACTIC, LLC
Entity type:Organization
Organization Name:SPINE TIME CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NATHAN
Authorized Official - Middle Name:THUAN
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:714-468-9622
Mailing Address - Street 1:2800 KIRBY DR APT B707
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77098-1491
Mailing Address - Country:US
Mailing Address - Phone:714-468-9622
Mailing Address - Fax:
Practice Address - Street 1:2240 W HOLCOMBE BLVD STE A
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2008
Practice Address - Country:US
Practice Address - Phone:832-934-7766
Practice Address - Fax:832-321-7240
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-14
Last Update Date:2024-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty