Healthcare Provider Details
I. General information
NPI: 1902994361
Provider Name (Legal Business Name): TOWNSEND CHIROPRACTIC & WELLNESS CENTER PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/11/2006
Last Update Date: 03/21/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
394 OLD ROUTE 66 STE 101
SAINT ROBERT MO
65584-3829
US
IV. Provider business mailing address
P.O. BOX 459
WAYNESVILLE MO
65583
US
V. Phone/Fax
- Phone: 573-336-4221
- Fax: 573-336-4714
- Phone: 573-336-4221
- Fax: 573-336-4714
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | 006067 |
| License Number State | MO |
VIII. Authorized Official
Name: MR.
RICK
L.
TOWNSEND
Title or Position: PRESIDENT
Credential: DC, NMD, LAC
Phone: 573-336-4221