Healthcare Provider Details

I. General information

NPI: 1487699393
Provider Name (Legal Business Name): CHIROSOLUTIONS, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2006
Last Update Date: 05/27/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2910 OKLAHOMA AVE
TRENTON MO
64683-3405
US

IV. Provider business mailing address

2910 OKLAHOMA AVE
TRENTON MO
64683-3405
US

V. Phone/Fax

Practice location:
  • Phone: 660-359-3500
  • Fax: 660-359-3511
Mailing address:
  • Phone: 660-359-3500
  • Fax: 660-359-3511

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2005035876
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2005035875
License Number StateMO

VIII. Authorized Official

Name: DR. CRYSTAL IOLA WHITAKER
Title or Position: SECRETARY
Credential: D.C.
Phone: 660-359-3500