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General NPI Number Information
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NPI Number | 1932690104
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Entity Type | Organization
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Legal Business Name | CUTTING EDGE CHIROPRACTIC LLC
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Dates
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Enumeration Date | 05/23/2018
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Last Update Date | 05/23/2018
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Provider Practice Location Address
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Address Line | 3001 WILDFLOWER DR STE 601
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City | BRYAN
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State | TX
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Zip | 77802-3061
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Country | US
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Telephone | 979-557-0995
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Fax |
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Provider Business Mailing Address
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Address Line | 4011 ALFORD ST
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City | COLLEGE STATION
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State | TX
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Zip | 77845-2051
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Country | US
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Telephone | 817-995-6856
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | PATRICK LINNE
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Credential | DC
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Telephone | 817-995-6856
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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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