Healthcare Provider Details

I. General information

NPI: 1194278077
Provider Name (Legal Business Name): ANGELA IMGARTEN D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/27/2016
Last Update Date: 08/11/2022
Certification Date: 08/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 N US HIGHWAY 65
CARROLLTON MO
64633-1975
US

IV. Provider business mailing address

1300 N US HIGHWAY 65
CARROLLTON MO
64633-1975
US

V. Phone/Fax

Practice location:
  • Phone: 660-542-2441
  • Fax:
Mailing address:
  • Phone: 660-542-2441
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2016014934
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: