Healthcare Provider Details

I. General information

NPI: 1841207883
Provider Name (Legal Business Name): JAMES WILLIAM OROURKE JR. DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/02/2006
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21505 STATE HIGHWAY 190
JAMESPORT MO
64648-7297
US

IV. Provider business mailing address

21505 STATE HIGHWAY 190
JAMESPORT MO
64648-7297
US

V. Phone/Fax

Practice location:
  • Phone: 660-684-6500
  • Fax: 660-684-6550
Mailing address:
  • Phone: 660-684-6500
  • Fax: 660-684-6550

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number006667
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: