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General NPI Number Information
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NPI Number | 1073098265
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Entity Type | Organization
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Legal Business Name | V.I.P. CHIROPRACTIC CARE, PLLC
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Dates
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Enumeration Date | 10/03/2018
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Last Update Date | 02/20/2023
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Provider Practice Location Address
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Address Line | 3115 S 1ST ST APT 101
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City | AUSTIN
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State | TX
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Zip | 78704-6357
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Country | US
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Telephone | 512-819-1113
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Fax | 512-641-8044
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Provider Business Mailing Address
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Address Line | 3115 S 1ST ST APT 101
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City | AUSTIN
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State | TX
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Zip | 78704-6357
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Country | US
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Telephone | 512-809-1113
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Fax | 512-895-9892
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Authorized Official
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Title or Position | OWNER
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Name | GLEN WILKINSON
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Credential | DC
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Telephone | 512-809-1113
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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