Provider Demographics
NPI:1487801098
Name:A&M CHIROPRACTIC
Entity type:Organization
Organization Name:A&M CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:T
Authorized Official - Last Name:MILNE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:817-572-0072
Mailing Address - Street 1:PO BOX 170156
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76003-0156
Mailing Address - Country:US
Mailing Address - Phone:817-572-0072
Mailing Address - Fax:
Practice Address - Street 1:4012 SW GREEN OAKS BLVD
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76017-4113
Practice Address - Country:US
Practice Address - Phone:817-572-0072
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-26
Last Update Date:2008-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5279111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX605588Medicare PIN