| |
8800 W State Highway 86, Shell Knob, MO 65747-9176 | |
(417) 858-8818 | |
(417) 858-8819 |
Full Name | |
---|---|
Type | Facility |
Speciality | Chiropractor |
Location | 8800 W State Highway 86, Shell Knob, Missouri |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1922312800 | NPI | - | NPPES |
756208302 | Medicaid | MO |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111N00000X | Chiropractor | 005235 (Missouri) | Primary |
171100000X | Acupuncturist | (Missouri) | Secondary |
Mailing Address | Practice Location Address |
---|---|
1134 W Maplewood St, Springfield, MO 65807-4763 Ph: (417) 522-9395 | 8800 W State Highway 86, Shell Knob, MO 65747-9176 Ph: (417) 858-8818 |