Provider Demographics
NPI:1386492692
Name:REDMAN CHIROPRACTIC LLC
Entity type:Organization
Organization Name:REDMAN CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:REDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:512-549-8389
Mailing Address - Street 1:6800 W GATE BLVD # 132212
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78745-4883
Mailing Address - Country:US
Mailing Address - Phone:512-549-8389
Mailing Address - Fax:
Practice Address - Street 1:6800 W GATE BLVD STE 117
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78745-4868
Practice Address - Country:US
Practice Address - Phone:512-549-8389
Practice Address - Fax:512-562-9242
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-10
Last Update Date:2024-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty