Healthcare Provider Details

I. General information

NPI: 1518040443
Provider Name (Legal Business Name): HEALING ARTS CENTER L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/23/2006
Last Update Date: 05/21/2020
Certification Date: 05/21/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 VIOLYN DR
BRANSON MO
65616-8128
US

IV. Provider business mailing address

225 VIOLYN DR
BRANSON MO
65616-8128
US

V. Phone/Fax

Practice location:
  • Phone: 417-334-6660
  • Fax: 417-334-6661
Mailing address:
  • Phone: 417-334-6660
  • Fax: 417-334-6661

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number006810
License Number StateMO
# 4
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2003012564
License Number StateMO

VIII. Authorized Official

Name: TRICIA SAMS
Title or Position: OWNER
Credential:
Phone: 417-334-6660