Healthcare Provider Details
I. General information
NPI: 1346270394
Provider Name (Legal Business Name): ABCS OF WELLNESS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/04/2006
Last Update Date: 03/03/2020
Certification Date: 03/03/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
139 E US HIGHWAY 54 STE 1C
CAMDENTON MO
65020-7320
US
IV. Provider business mailing address
139 E. HWY 54, 1C
CAMDENTON MO
65020-2621
US
V. Phone/Fax
- Phone: 573-348-3050
- Fax:
- Phone: 573-348-3050
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | 2002024753 |
| License Number State | MO |
VIII. Authorized Official
Name: DR.
KARIN
G
BURMEISTER
Title or Position: CHIROPRACTOR
Credential: D.C.
Phone: 573-346-3050