Provider Demographics
NPI:1891840666
Name:BRATCHER INJURY & WELLNESS CENTER, P.A.
Entity type:Organization
Organization Name:BRATCHER INJURY & WELLNESS CENTER, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LUTHER
Authorized Official - Middle Name:BURBANK
Authorized Official - Last Name:BRATCHER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:903-561-6676
Mailing Address - Street 1:2140 W. GRANDE BLVD.
Mailing Address - Street 2:SUITE A
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75703
Mailing Address - Country:US
Mailing Address - Phone:903-561-6676
Mailing Address - Fax:903-561-7071
Practice Address - Street 1:2140 W. GRANDE BLVD.
Practice Address - Street 2:SUITE A
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75703
Practice Address - Country:US
Practice Address - Phone:903-561-6676
Practice Address - Fax:903-561-7071
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-24
Last Update Date:2010-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Single Specialty