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General NPI Number Information
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NPI Number | 1275360968
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Entity Type | Organization
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Legal Business Name | PREMIER CHIROPRACTIC & WELLNESS LLC
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Dates
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Enumeration Date | 09/17/2024
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Last Update Date | 09/17/2024
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Provider Practice Location Address
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Address Line | 2101 PLAZA DR
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City | HARRISONVILLE
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State | MO
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Zip | 64701-1265
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Country | US
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Telephone | 785-477-0126
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Fax |
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Provider Business Mailing Address
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Address Line | 2101 PLAZA DR
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City | HARRISONVILLE
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State | MO
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Zip | 64701-1265
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ERIC DEAN DIERKSEN
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Credential | DC
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Telephone | 785-477-0126
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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