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General NPI Number Information
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NPI Number | 1982930749
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Entity Type | Organization
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Legal Business Name | ALLEN CHIROPRACTIC WELLNESS CENTER
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Dates
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Enumeration Date | 10/28/2009
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Last Update Date | 10/28/2009
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Provider Practice Location Address
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Address Line | 1018 S WESTWOOD BLVD SUITE 5
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City | POPLAR BLUFF
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State | MO
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Zip | 63901-6108
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Country | US
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Telephone | 573-778-0500
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Fax | 573-778-0160
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Provider Business Mailing Address
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Address Line | 1018 S WESTWOOD BLVD SUITE 5
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City | POPLAR BLUFF
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State | MO
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Zip | 63901-6108
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Country | US
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Telephone | 573-778-0500
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Fax | 573-778-0160
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Authorized Official
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Title or Position | OWNER
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Name | DR. LAURIE M ALLEN
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Credential | D.C., F.I.A.M.A.
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Telephone | 573-778-0500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | CE 6097
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License Number State | MO
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