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General NPI Number Information
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NPI Number | 1356090096
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Entity Type | Organization
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Legal Business Name | CARROLLTON CHIROPRACTIC CLINIC, LLC
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Dates
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Enumeration Date | 03/21/2022
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Last Update Date | 08/11/2022
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Provider Practice Location Address
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Address Line | 1300 N US HIGHWAY 65 STE A&B
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City | CARROLLTON
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State | MO
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Zip | 64633-1975
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Country | US
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Telephone | 660-542-2441
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Fax | 660-542-2442
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Provider Business Mailing Address
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Address Line | 1300 N US HIGHWAY 65 STE A&B
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City | CARROLLTON
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State | MO
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Zip | 64633-1975
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Country | US
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Telephone | 660-542-2441
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Fax | 660-542-2442
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | KELSEY HOWELL
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Credential |
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Telephone | 660-542-2441
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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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