| Carl L. Blomenkamp,d.c.,p.c. | |
|
2853 W Broadway St Bolivar MO 65613-3379 | |
| (417) 326-3888 | |
| Not Available |
| Full Name | Carl L. Blomenkamp,d.c.,p.c. |
|---|---|
| Speciality | Clinic/center |
| Location | 2853 W Broadway St, Bolivar, Missouri |
| Authorized Official Name and Position | Carl Lawrence Blomenkamp (DIRECTOR) |
| Authorized Official Contact | 4173263888 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Carl L. Blomenkamp,d.c.,p.c. 2853 W Broadway St Po Box 16 Bolivar MO 65613-3379 Ph: (417) 326-3888 | Carl L. Blomenkamp,d.c.,p.c. 2853 W Broadway St Bolivar MO 65613-3379 Ph: (417) 326-3888 |
| NPI Number | 1316265127 |
|---|---|
| Provider Enumeration Date | 05/04/2010 |
| Last Update Date | 05/04/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316265127 | NPI | - | NPPES |
| 5008 | Other | MO | CHIROPRACTIC LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 5008 (Missouri) | Primary |
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