Healthcare Provider Details

I. General information

NPI: 1508165861
Provider Name (Legal Business Name): RELIEF CHIROPRACTIC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/24/2011
Last Update Date: 04/21/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

127 S MAIN STREET USA
MARCELINE MO
64658-1215
US

IV. Provider business mailing address

127 S MAIN STREET USA
MARCELINE MO
64658-1215
US

V. Phone/Fax

Practice location:
  • Phone: 660-376-3331
  • Fax:
Mailing address:
  • Phone: 660-376-3331
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number2010040156
License Number StateMO

VIII. Authorized Official

Name: DR. AMANDA ENGELHARD
Title or Position: OWNER
Credential: D.C
Phone: 660-376-3331