Provider Demographics
NPI:1538483466
Name:CHIROPRACTIC & REHAB CENTERS, INC
Entity type:Organization
Organization Name:CHIROPRACTIC & REHAB CENTERS, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:L
Authorized Official - Last Name:PUCKETT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:817-306-8585
Mailing Address - Street 1:705 W BAILEY BOSWELL RD STE 200
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:TX
Mailing Address - Zip Code:76179-1020
Mailing Address - Country:US
Mailing Address - Phone:817-306-8585
Mailing Address - Fax:817-306-8589
Practice Address - Street 1:705 W BAILEY BOSWELL RD
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:TX
Practice Address - Zip Code:76179-1020
Practice Address - Country:US
Practice Address - Phone:817-306-8585
Practice Address - Fax:817-306-8589
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-22
Last Update Date:2023-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8264111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty