| Sport And Spine Chiropractic Center Llc | |
|
810 E Highway M Warrenton MO 63383-2215 | |
| (636) 456-2966 | |
| (636) 456-2977 |
| Full Name | Sport And Spine Chiropractic Center Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 810 E Highway M, Warrenton, Missouri |
| Authorized Official Name and Position | Ginger Leah Sharp (CFO) |
| Authorized Official Contact | 6364562966 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sport And Spine Chiropractic Center Llc 810 E Highway M Warrenton MO 63383-2215 Ph: (636) 456-2966 | Sport And Spine Chiropractic Center Llc 810 E Highway M Warrenton MO 63383-2215 Ph: (636) 456-2966 |
| NPI Number | 1083934517 |
|---|---|
| Provider Enumeration Date | 06/07/2010 |
| Last Update Date | 06/07/2010 |
| Medicare PECOS PAC ID | 5496889701 |
|---|---|
| Medicare Enrollment ID | O20100820001084 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083934517 | NPI | - | NPPES |
| 1699975995 | Other | MO | INDIVIDUAL NPI (JOSHUA D. SHARP, D.C.) |
| 1730253659 | Other | MO | INDIVIDUAL NPI (GINGER SHARP, D.C.) |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 2006030811 (Missouri) | Primary |
| Provider Name | Ginger L Sharp |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1730253659 PECOS PAC ID: 9032212402 Enrollment ID: I20070306000328 |
| Provider Name | Joshua D Sharp |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1699975995 PECOS PAC ID: 6608069190 Enrollment ID: I20101015000924 |
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