Healthcare Provider Details

I. General information

NPI: 1073992509
Provider Name (Legal Business Name): LAMOUREUX CHIROPRACTIC CENTRE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/29/2015
Last Update Date: 05/29/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8 OAK TREE VLG
DONIPHAN MO
63935-1901
US

IV. Provider business mailing address

8 OAK TREE VLG
DONIPHAN MO
63935-1901
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number005265
License Number StateMO

VIII. Authorized Official

Name: DR. LESTER A. LAMOUREUX
Title or Position: OWNER
Credential: D.C.
Phone: 573-996-7276