Healthcare Provider Details

I. General information

NPI: 1154350973
Provider Name (Legal Business Name): TRUE CHIROPRACTIC AND REHABILITATION, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2006
Last Update Date: 06/23/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3986 DOWLEN RD
BEAUMONT TX
77706-6847
US

IV. Provider business mailing address

3986 DOWLEN RD
BEAUMONT TX
77706-6847
US

V. Phone/Fax

Practice location:
  • Phone: 409-833-9505
  • Fax: 409-833-9525
Mailing address:
  • Phone: 409-833-9505
  • Fax: 409-833-9525

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number6932
License Number StateTX

VIII. Authorized Official

Name: DR. CRAIG A. THIRY
Title or Position: CHIROPRACTOR/PROPRIETOR
Credential: D.C.
Phone: 409-833-9505