Healthcare Provider Details

I. General information

NPI: 1295937423
Provider Name (Legal Business Name): ALLIED PHYSICIANS GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2007
Last Update Date: 12/23/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

244 E PRIMROSE ST
SPRINGFIELD MO
65807-5206
US

IV. Provider business mailing address

PO BOX 790126 DEPT. 30705
ST. LOUIS MO
63179-0126
US

V. Phone/Fax

Practice location:
  • Phone: 417-315-9602
  • Fax: 636-600-5042
Mailing address:
  • Phone: 314-275-8737
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number2003006353
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberMO100753
License Number StateMO

VIII. Authorized Official

Name: MR. KEVIN MEURET
Title or Position: OWNER
Credential: DC
Phone: 314-275-8737