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General NPI Number Information
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NPI Number | 1427937481
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Entity Type | Organization
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Legal Business Name | RENOWNED CHIROPRACTIC LLC
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Dates
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Enumeration Date | 09/02/2025
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Last Update Date | 09/02/2025
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Provider Practice Location Address
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Address Line | 209 MAIN ST
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City | SLATER
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State | MO
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Zip | 65349-1411
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Country | US
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Telephone | 660-851-3501
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Fax |
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Provider Business Mailing Address
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Address Line | 209 MAIN ST
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City | SLATER
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State | MO
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Zip | 65349-1411
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Country | US
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Telephone | 660-851-3501
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Fax |
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. STEVEN ELLEFSEN
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Credential | DC
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Telephone | 402-507-7272
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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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