MEDICARE: FAMILY CHIROPRACTIC CLINIC, PC

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
1	111N00000X	Chiropractor	5709	MO

General Provider Information

NPI Number	:	1952689101
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAMILY CHIROPRACTIC CLINIC, PC

Provider Business Mailing Address
First Line	:	5886 OSAGE BEACH PKWY STE B
Second Line	:
City	:	OSAGE BEACH
State	:	MO
Zip	:	65065-3040
Country	:	US
Telephone Number	:	573-348-6640
Fax Number	:

Provider Business Practice Location Address
First Line	:	5886 OSAGE BEACH PKWY STE B
Second Line	:
City	:	OSAGE BEACH
State	:	MO
Zip	:	65065-3040
Country	:	US
Telephone Number	:	573-348-6640
Fax Number	:

Authorized Official
Title or Position	:	DOCTOR
Name	:	AARON RIEDEL
Credential	:	DC
Telephone Number	:	573-348-6640

Provider Enumeration Date	:	07/21/2011
Last Update Date	:	02/27/2025

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