| Organization Name: | RISING CHIROPRACTIC CLINIC |
| NPI Number: | 1073799334 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | BODRE M RISING (CHIROPRACTOR) |
| Mailing Address: | 5755 College St Beaumont |
| State: | TX US |
| Postal Code: | 777073518 |
| Phone Number: | 4098409300 |
| Fax Number: | 4098424960 |
| NPI Enumeration Date: | 01/17/2008 |
| NPI Last Update Date: | 08/19/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332B00000X |
| License Number: | DC8324 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | TX |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |