Healthcare Provider Details

I. General information

NPI: 1780780700
Provider Name (Legal Business Name): JAMES ROY D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1106 OLD ROUTE 66 SUITE 2D
SAINT ROBERT MO
65584-4601
US

IV. Provider business mailing address

PO BOX 797
SAINT ROBERT MO
65584-0797
US

V. Phone/Fax

Practice location:
  • Phone: 573-336-2230
  • Fax: 573-336-4285
Mailing address:
  • Phone: 573-336-2230
  • Fax: 573-336-4285

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number006439
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: