MEDICARE: ACHIEVE BALANCE 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	111N00000X	Chiropractor	2008005854	MO

General Provider Information

NPI Number	:	1629243340
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ACHIEVE BALANCE CHIROPRACTIC LLC

Provider Business Mailing Address
First Line	:	2700 FORUM BLVD
Second Line	:
City	:	COLUMBIA
State	:	MO
Zip	:	65203-5433
Country	:	US
Telephone Number	:	573-442-5520
Fax Number	:	573-442-5524

Provider Business Practice Location Address
First Line	:	2700 FORUM BLVD
Second Line	:
City	:	COLUMBIA
State	:	MO
Zip	:	65203-5433
Country	:	US
Telephone Number	:	573-442-5520
Fax Number	:	573-442-5524

Authorized Official
Title or Position	:	OWNER
Name	:	DR. ARMINTA FRANCES PHELPS
Credential	:	D.C.
Telephone Number	:	314-570-7868

Provider Enumeration Date	:	04/23/2008
Last Update Date	:	09/19/2022

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