Healthcare Provider Details

I. General information

NPI: 1013124866
Provider Name (Legal Business Name): BEVIER FAMILY CHIROPRACTIC CLINIC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

206 N MACON ST
BEVIER MO
63532-1059
US

IV. Provider business mailing address

206 N MACON ST
BEVIER MO
63532-1059
US

V. Phone/Fax

Practice location:
  • Phone: 660-773-6777
  • Fax:
Mailing address:
  • Phone: 660-773-6777
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NN0400X
TaxonomyNeurology Chiropractor
License Number006323
License Number StateMO

VIII. Authorized Official

Name: DR. LOUIS ALBERT FIQUET III
Title or Position: OWNER
Credential: D.C., R.N.
Phone: 660-773-6777