Healthcare Provider Details

I. General information

NPI: 1053435883
Provider Name (Legal Business Name): ENJOY GREAT HEALTH CHIROPRACTIC, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/19/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

305 EAST BROADWAY SUITE C
ASHLAND MO
65010
US

IV. Provider business mailing address

305 EAST BROADWAY SUITE C
ASHLAND MO
65010
US

V. Phone/Fax

Practice location:
  • Phone: 573-657-2211
  • Fax:
Mailing address:
  • Phone: 573-657-2211
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2006010204
License Number StateMO

VIII. Authorized Official

Name: DR. BRENT RAY BERLENER
Title or Position: PRESIDENT
Credential: D.C.
Phone: 573-657-2211