Provider Demographics
NPI:1023829488
Name:GREENVILLE AVENUE CHIROPRACTIC
Entity type:Organization
Organization Name:GREENVILLE AVENUE CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EILEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:PSENCIK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:214-823-1323
Mailing Address - Street 1:7515 GREENVILLE AVE STE 904
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-3834
Mailing Address - Country:US
Mailing Address - Phone:214-823-1323
Mailing Address - Fax:241-823-1035
Practice Address - Street 1:7515 GREENVILLE AVE STE 904
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-3834
Practice Address - Country:US
Practice Address - Phone:214-823-1323
Practice Address - Fax:241-823-1035
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-15
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No111NN0400XChiropractic ProvidersChiropractorNeurologyGroup - Multi-Specialty