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General NPI Number Information
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NPI Number | 1770629743
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Entity Type | Organization
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Legal Business Name | PAUL R LUMPKIN JR DC CHIROPRACTOR INC
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Dates
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Enumeration Date | 01/29/2007
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Last Update Date | 08/10/2012
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Provider Practice Location Address
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Address Line | 409 W OSAGE ST
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City | PACIFIC
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State | MO
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Zip | 63069-1332
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Country | US
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Telephone | 636-271-2960
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Fax | 636-271-9165
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Provider Business Mailing Address
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Address Line | 409 W OSAGE ST
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City | PACIFIC
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State | MO
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Zip | 63069-1332
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Country | US
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Telephone | 636-271-2960
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Fax | 636-271-9165
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. PAUL R LUMPKIN
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Credential | DC
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Telephone | 636-271-2960
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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 | 003358
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License Number State | MO
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