Healthcare Provider Details

I. General information

NPI: 1649900499
Provider Name (Legal Business Name): CURRENT RIVER CHIROPRACTIC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/14/2022
Last Update Date: 08/17/2023
Certification Date: 08/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8 OAK TREE VLG
DONIPHAN MO
63935-1901
US

IV. Provider business mailing address

301 LEROUX ST STE B
DONIPHAN MO
63935-1035
US

V. Phone/Fax

Practice location:
  • Phone: 573-996-7276
  • Fax: 573-996-4657
Mailing address:
  • Phone: 573-996-7276
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. COLBY LOVELACE
Title or Position: MEMBER
Credential:
Phone: 573-996-7276