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General NPI Number Information
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NPI Number | 1154037562
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Entity Type | Organization
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Legal Business Name | RISE FAMILY CHIROPRACTIC LLC
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Dates
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Enumeration Date | 01/30/2023
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Last Update Date | 01/30/2023
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Provider Practice Location Address
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Address Line | 1082 CROSSWINDS CT
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City | WENTZVILLE
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State | MO
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Zip | 63385-4836
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Country | US
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Telephone | 330-502-6306
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Fax |
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Provider Business Mailing Address
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Address Line | 709 CROOKED LAKE CT
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City | SAINT CHARLES
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State | MO
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Zip | 63304-1068
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Country | US
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Telephone | 330-502-6306
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KALLLIE FISCHER
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Credential |
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Telephone | 330-502-6306
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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