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NPI Code Detail

MEDICARE: COMMUNITY CHIROPRACTIC, PLLC

MEDICARE: COMMUNITY CHIROPRACTIC, PLLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111N00000XChiropractor8513TX

General Provider Information

NPI Number : 1336473578
Entity Type Code : Organization
Provider Name (Legal Business Name) : COMMUNITY CHIROPRACTIC, PLLC
Provider Business Mailing Address
First Line : 2646 HIGHWAY 36 S
Second Line :
City : BRENHAM
State : TX
Zip : 77833-9600
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2646 HIGHWAY 36 S
Second Line :
City : BRENHAM
State : TX
Zip : 77833-9600
Country : US
Telephone Number : 979-251-8111
Fax Number : 979-251-8110
Authorized Official
Title or Position : PRESIDENT
Name : DR. BRUCE LEE
Credential : D.C.
Telephone Number : 979-251-8111
Provider Enumeration Date : 09/21/2009
Last Update Date : 12/11/2009

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Directions to “COMMUNITY CHIROPRACTIC, PLLC ” Practice Location

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