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General NPI Number Information
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NPI Number | 1205026176
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Entity Type | Organization
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Legal Business Name | HART CARE CHIROPRACTIC CENTER
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Dates
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Enumeration Date | 07/27/2007
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Last Update Date | 07/27/2007
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Provider Practice Location Address
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Address Line | 300 W MAIN ST
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City | BOWLING GREEN
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State | MO
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Zip | 63334-1561
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Country | US
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Telephone | 573-324-2225
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Fax | 573-324-6250
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Provider Business Mailing Address
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Address Line | 300 W MAIN ST PO BOX 308
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City | BOWLING GREEN
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State | MO
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Zip | 63334-1561
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Country | US
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Telephone | 537-324-2225
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Fax | 537-324-6250
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Authorized Official
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Title or Position | SOLE PROPRIETOR
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Name | L SHANE HART
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Credential | D.C.
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Telephone | 573-324-2225
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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 | 005241
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License Number State | MO
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