| Advanced Health & Rehab Llc | |
|
3120 S Main St Ste 5 Joplin MO 64804-2608 | |
| (417) 782-2504 | |
| (417) 553-7760 |
| Full Name | Advanced Health & Rehab Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 3120 S Main St, Joplin, Missouri |
| Authorized Official Name and Position | James R. Lewis (ADMINISTRATOR) |
| Authorized Official Contact | 4177822504 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Advanced Health & Rehab Llc 3120 S Main St Ste 5 Joplin MO 64804-2608 Ph: (417) 782-2504 | Advanced Health & Rehab Llc 3120 S Main St Ste 5 Joplin MO 64804-2608 Ph: (417) 782-2504 |
| NPI Number | 1992762942 |
|---|---|
| Provider Enumeration Date | 04/26/2006 |
| Last Update Date | 07/25/2016 |
| Medicare PECOS PAC ID | 4587550827 |
|---|---|
| Medicare Enrollment ID | O20041210000647 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992762942 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | 006161 (Missouri) | Primary |
| 261QM1300X | Clinic/center - Multi-specialty | 20044021789 (Missouri) | Secondary |
| Provider Name | James Lewis |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1609092089 PECOS PAC ID: 6002702347 Enrollment ID: I20041213000087 |
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