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General NPI Number Information
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NPI Number | 1598126542
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Entity Type | Organization
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Legal Business Name | BACK IN BALANCE CHIROPRACTIC
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Dates
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Enumeration Date | 03/17/2016
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Last Update Date | 03/17/2016
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Provider Practice Location Address
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Address Line | 1903 E 183RD ST
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City | BELTON
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State | MO
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Zip | 64012-9708
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Country | US
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Telephone | 816-682-0183
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Fax |
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Provider Business Mailing Address
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Address Line | 1903 E 183RD ST
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City | BELTON
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State | MO
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Zip | 64012-9708
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Country | US
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Telephone | 816-682-0183
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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. THOMAS JOHN MONNIG
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Credential | DC
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Telephone | 816-682-0183
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NN1001X
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Taxonomy Name | Nutrition Chiropractor
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License Number | 20130333219
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License Number State | MO
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