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NPI Code Detail

MEDICARE: CARROLLTON CHIROPRACTIC CLINIC, LLC

MEDICARE: CARROLLTON CHIROPRACTIC CLINIC, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111N00000XChiropractor

General Provider Information

NPI Number : 1356090096
Entity Type Code : Organization
Provider Name (Legal Business Name) : CARROLLTON CHIROPRACTIC CLINIC, LLC
Provider Business Mailing Address
First Line : 1300 N US HIGHWAY 65 STE A&B
Second Line :
City : CARROLLTON
State : MO
Zip : 64633-1975
Country : US
Telephone Number : 660-542-2441
Fax Number : 660-542-2442
Provider Business Practice Location Address
First Line : 1300 N US HIGHWAY 65 STE A&B
Second Line :
City : CARROLLTON
State : MO
Zip : 64633-1975
Country : US
Telephone Number : 660-542-2441
Fax Number : 660-542-2442
Authorized Official
Title or Position : OFFICE MANAGER
Name : KELSEY HOWELL
Credential :
Telephone Number : 660-542-2441
Provider Enumeration Date : 03/21/2022
Last Update Date : 08/11/2022

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Directions to “CARROLLTON CHIROPRACTIC CLINIC, LLC ” Practice Location

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