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General NPI Number Information
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NPI Number | 1558414896
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Entity Type | Organization
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Legal Business Name | NAGLE CHIROPRACTIC CENTER, P.C.
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Dates
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Enumeration Date | 01/19/2007
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Last Update Date | 12/17/2015
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Provider Practice Location Address
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Address Line | 808 E WAKEFIELD AVE SUITE A
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City | SIKESTON
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State | MO
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Zip | 63801-5147
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Country | US
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Telephone | 573-472-4470
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Fax | 573-472-4139
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Provider Business Mailing Address
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Address Line | 808 E WAKEFIELD AVE SUITE A
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City | SIKESTON
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State | MO
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Zip | 63801-5147
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Country | US
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Telephone | 573-472-4470
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Fax | 573-472-4139
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JEFFREY NAGLE
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Credential | D.C.
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Telephone | 573-474-4470
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NS0005X
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Taxonomy Name | Sports Physician Chiropractor
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License Number | 005752
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License Number State | MO
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