Provider Demographics
NPI:1730852948
Name:TIPTON CHIROPRACTIC LLC
Entity type:Organization
Organization Name:TIPTON CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:TIPTON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:623-225-6300
Mailing Address - Street 1:8106 BRODIE LN STE 107
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78745-7468
Mailing Address - Country:US
Mailing Address - Phone:512-442-7999
Mailing Address - Fax:512-442-8244
Practice Address - Street 1:8106 BRODIE LN STE 107
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78745-7468
Practice Address - Country:US
Practice Address - Phone:512-442-7999
Practice Address - Fax:512-442-8244
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-26
Last Update Date:2021-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service