MEDICARE: TIPTON CHIROPRACTIC LLC

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
1	305S00000X	Point of Service

General Provider Information

NPI Number	:	1730852948
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TIPTON CHIROPRACTIC LLC

Provider Business Mailing Address
First Line	:	8106 BRODIE LN STE 107
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78745-7468
Country	:	US
Telephone Number	:	512-442-7999
Fax Number	:	512-442-8244

Provider Business Practice Location Address
First Line	:	8106 BRODIE LN STE 107
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78745-7468
Country	:	US
Telephone Number	:	512-442-7999
Fax Number	:	512-442-8244

Authorized Official
Title or Position	:	OWNER
Name	:	SEAN THOMAS TIPTON
Credential	:	DC
Telephone Number	:	623-225-6300

Provider Enumeration Date	:	07/26/2021
Last Update Date	:	07/26/2021

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