Healthcare Provider Details

I. General information

NPI: 1255753000
Provider Name (Legal Business Name): MCFARLAND SPINE AND SPORT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/14/2014
Last Update Date: 01/14/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

311 PINE ST
WEST PLAINS MO
65775-2533
US

IV. Provider business mailing address

2054 C R 6460
WEST PLAINS MO
65775-6304
US

V. Phone/Fax

Practice location:
  • Phone: 417-293-9172
  • Fax:
Mailing address:
  • Phone: 417-293-9172
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2014000855
License Number StateMO

VIII. Authorized Official

Name: DR. MATTHEW ALDEN MCFARLAND
Title or Position: DR. OF CHIROPRACTIC
Credential: D.C.
Phone: 417-293-9172