Provider Demographics
NPI:1265236541
Name:BALLENGER, LAYN (DC)
Entity type:Individual
Prefix:DR
First Name:LAYN
Middle Name:
Last Name:BALLENGER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2107 COURTHOUSE DR STE 107
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:75605-2355
Mailing Address - Country:US
Mailing Address - Phone:903-218-2198
Mailing Address - Fax:
Practice Address - Street 1:2107 COURTHOUSE DR STE 107
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75605-2355
Practice Address - Country:US
Practice Address - Phone:903-218-2198
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-03
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16024111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor