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NPI Code Detail

MEDICARE: BLACKBURN CHIROPRACTIC PLLC

MEDICARE: BLACKBURN 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
1111N00000XChiropractor10841TX

General Provider Information

NPI Number : 1942446067
Entity Type Code : Organization
Provider Name (Legal Business Name) : BLACKBURN CHIROPRACTIC PLLC
Provider Business Mailing Address
First Line : 4107 MEDICAL PKWY STE 100
Second Line :
City : AUSTIN
State : TX
Zip : 78756-3736
Country : US
Telephone Number : 512-810-0667
Fax Number : 512-420-9390
Provider Business Practice Location Address
First Line : 4107 MEDICAL PKWY STE 100
Second Line :
City : AUSTIN
State : TX
Zip : 78756-3736
Country : US
Telephone Number : 512-810-0667
Fax Number : 512-420-9390
Authorized Official
Title or Position : SOLE PROPRIETOR, OWNER
Name : DR. ABIGAIL HOLLIS BLACKBURN
Credential : DC
Telephone Number : 512-420-9300
Provider Enumeration Date : 12/18/2008
Last Update Date : 01/08/2018

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Directions to “BLACKBURN CHIROPRACTIC PLLC ” Practice Location

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