Provider Demographics
NPI:1447549027
Name:THE CARPENTER'S TOUCH CHIROPRACTIC WELLNESS CENTER, P.A.
Entity type:Organization
Organization Name:THE CARPENTER'S TOUCH CHIROPRACTIC WELLNESS CENTER, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHAD
Authorized Official - Middle Name:A
Authorized Official - Last Name:CARPENTER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:830-816-4357
Mailing Address - Street 1:1510 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BOERNE
Mailing Address - State:TX
Mailing Address - Zip Code:78006-3308
Mailing Address - Country:US
Mailing Address - Phone:830-816-4357
Mailing Address - Fax:830-331-8718
Practice Address - Street 1:1510 S MAIN ST
Practice Address - Street 2:
Practice Address - City:BOERNE
Practice Address - State:TX
Practice Address - Zip Code:78006-3308
Practice Address - Country:US
Practice Address - Phone:830-816-4357
Practice Address - Fax:830-331-8718
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-04
Last Update Date:2016-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXTX-8280111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX006WMOtherBCBS
DS2414OtherRR MEDICARE PTAN
DS2414OtherRR MEDICARE PTAN
TXB134550Medicare PIN