Provider Demographics
NPI:1679295208
Name:DARBY CHIROPRACTIC & SPORTS PERFORMANCE LLC
Entity type:Organization
Organization Name:DARBY CHIROPRACTIC & SPORTS PERFORMANCE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KAMON
Authorized Official - Middle Name:
Authorized Official - Last Name:DARBY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:409-273-4309
Mailing Address - Street 1:2240 DIAMOND D DR
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77713-5300
Mailing Address - Country:US
Mailing Address - Phone:409-273-4309
Mailing Address - Fax:
Practice Address - Street 1:2240 DIAMOND D DR
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77713-5300
Practice Address - Country:US
Practice Address - Phone:409-273-4309
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-12
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service