Provider Demographics
NPI:1144576752
Name:ADVANCED CHIROSPORT INC
Entity type:Organization
Organization Name:ADVANCED CHIROSPORT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NEIL
Authorized Official - Middle Name:
Authorized Official - Last Name:DUKES
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:972-578-2225
Mailing Address - Street 1:345 W FM 544 STE 200
Mailing Address - Street 2:
Mailing Address - City:MURPHY
Mailing Address - State:TX
Mailing Address - Zip Code:75094-4577
Mailing Address - Country:US
Mailing Address - Phone:972-578-2225
Mailing Address - Fax:972-578-2201
Practice Address - Street 1:345 W FM 544 STE 200
Practice Address - Street 2:
Practice Address - City:MURPHY
Practice Address - State:TX
Practice Address - Zip Code:75094-4577
Practice Address - Country:US
Practice Address - Phone:972-578-2225
Practice Address - Fax:972-578-2201
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-01
Last Update Date:2012-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty