Provider Demographics
NPI:1053533109
Name:AUSTIN FAMILY CHIROPRACTICE, INC.
Entity type:Organization
Organization Name:AUSTIN FAMILY CHIROPRACTICE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TODD
Authorized Official - Middle Name:W
Authorized Official - Last Name:AUSTIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:217-965-3100
Mailing Address - Street 1:157 N SPRINGFIELD ST
Mailing Address - Street 2:
Mailing Address - City:VIRDEN
Mailing Address - State:IL
Mailing Address - Zip Code:62690-1455
Mailing Address - Country:US
Mailing Address - Phone:217-965-3100
Mailing Address - Fax:845-875-0531
Practice Address - Street 1:157 N SPRINGFIELD ST
Practice Address - Street 2:
Practice Address - City:VIRDEN
Practice Address - State:IL
Practice Address - Zip Code:62690-1455
Practice Address - Country:US
Practice Address - Phone:217-965-3100
Practice Address - Fax:845-875-0531
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-02
Last Update Date:2011-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty