Healthcare Provider Details

I. General information

NPI: 1760415988
Provider Name (Legal Business Name): OROURKE WELLNESS CENTER PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

122 N MARKET ST
GALLATIN MO
64640-1156
US

IV. Provider business mailing address

122 N MARKET ST
GALLATIN MO
64640-1156
US

V. Phone/Fax

Practice location:
  • Phone: 660-663-2101
  • Fax: 660-663-2150
Mailing address:
  • Phone: 660-663-2101
  • Fax: 660-663-2150

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: JAMES WILLIAM OROURKE JR.
Title or Position: PRESIDENT
Credential: DC
Phone: 660-663-2101