Provider Demographics
NPI:1306523790
Name:TROWBRIDGE CHIROPRACTIC CLINIC, LLC
Entity type:Organization
Organization Name:TROWBRIDGE CHIROPRACTIC CLINIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TARA
Authorized Official - Middle Name:JANE MARIE
Authorized Official - Last Name:TROWBRIDGE
Authorized Official - Suffix:
Authorized Official - Credentials:DC, MS
Authorized Official - Phone:956-543-5829
Mailing Address - Street 1:11200 MENCHACA RD STE 303
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78748-2761
Mailing Address - Country:US
Mailing Address - Phone:956-543-5829
Mailing Address - Fax:
Practice Address - Street 1:11200 MENCHACA RD STE 303
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78748-2761
Practice Address - Country:US
Practice Address - Phone:956-543-5829
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-28
Last Update Date:2023-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center