Provider Demographics
NPI:1053148254
Name:PERRY CHIROPRACTIC LLC
Entity type:Organization
Organization Name:PERRY CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:A
Authorized Official - Last Name:CARROLL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:214-603-6894
Mailing Address - Street 1:624 S SEGUIN AVE
Mailing Address - Street 2:
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78130-7647
Mailing Address - Country:US
Mailing Address - Phone:214-203-6894
Mailing Address - Fax:877-559-0627
Practice Address - Street 1:624 S SEGUIN AVE
Practice Address - Street 2:
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130-7647
Practice Address - Country:US
Practice Address - Phone:214-203-6894
Practice Address - Fax:877-559-0627
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-19
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty