Healthcare Provider Details

I. General information

NPI: 1952402620
Provider Name (Legal Business Name): HILTON HEALTH AND WELLNESS CHIROPRACTIC L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/26/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 W. MCCLURG AVE.
RICHLAND MO
65556
US

IV. Provider business mailing address

PO BOX 378
RICHLAND MO
65556-0378
US

V. Phone/Fax

Practice location:
  • Phone: 573-765-2606
  • Fax: 573-765-2607
Mailing address:
  • Phone: 573-765-2606
  • Fax: 573-765-2607

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2006021424
License Number StateMO

VIII. Authorized Official

Name: SHAD ALAN HILTON
Title or Position: OWNER/CLINIC DIRECTOR
Credential: D.C.
Phone: 573-765-2606