Healthcare Provider Details

I. General information

NPI: 1871765669
Provider Name (Legal Business Name): WORDEN CHIROPRACTIC AND HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/01/2008
Last Update Date: 04/01/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

305 N HWY 21
PILOT KNOB MO
63663-0306
US

IV. Provider business mailing address

P.O. BOX 306 305 N HWY 21
PILOT KNOB MO
63663-0306
US

V. Phone/Fax

Practice location:
  • Phone: 573-546-0882
  • Fax: 573-546-7812
Mailing address:
  • Phone: 573-546-0882
  • Fax: 573-546-7812

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License Number2007023074
License Number StateMO

VIII. Authorized Official

Name: DR. JOSEPH DONALD WORDEN III
Title or Position: CHIROPRACTOR/OWNER
Credential: D.C.
Phone: 573-546-0882