Provider Demographics
NPI:1528484599
Name:AUSTIN CHIROPRACTIC CENTER INC
Entity type:Organization
Organization Name:AUSTIN CHIROPRACTIC CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:DONALD
Authorized Official - Last Name:AUSTIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:303-665-5405
Mailing Address - Street 1:362 S MCCASLIN BLVD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:CO
Mailing Address - Zip Code:80027-9432
Mailing Address - Country:US
Mailing Address - Phone:303-665-5405
Mailing Address - Fax:303-664-1697
Practice Address - Street 1:362 S MCCASLIN BLVD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:CO
Practice Address - Zip Code:80027-9432
Practice Address - Country:US
Practice Address - Phone:303-665-5405
Practice Address - Fax:303-664-1697
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-13
Last Update Date:2014-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCHR 0002738261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC441538Medicare PIN