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General NPI Number Information
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NPI Number | 1760546584
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Entity Type | Organization
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Legal Business Name | CARLSON CHIROPRACTIC CENTER PC
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Dates
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Enumeration Date | 12/20/2006
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Last Update Date | 06/02/2009
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Provider Practice Location Address
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Address Line | 2318 E 32ND STREET SUITE B
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City | JOPLIN
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State | MO
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Zip | 64804-0923
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Country | US
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Telephone | 417-781-6300
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Fax | 417-781-6309
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Provider Business Mailing Address
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Address Line | 2318 E 32ND STREET SUITE B
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City | JOPLIN
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State | MO
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Zip | 64804-0923
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Country | US
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Telephone | 417-781-6300
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Fax | 417-781-6309
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Authorized Official
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Title or Position | PRESIDENT
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Name | STEVEN M CARLSON
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Credential | DC
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Telephone | 417-781-6300
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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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