1902994361 NPI number — TOWNSEND CHIROPRACTIC & WELLNESS CENTER PC

Table of content: (NPI 1902994361)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1902994361 NPI number — TOWNSEND CHIROPRACTIC & WELLNESS CENTER PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TOWNSEND CHIROPRACTIC & WELLNESS CENTER PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1902994361
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/21/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
P.O. BOX 459
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WAYNESVILLE
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
65583
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
573-336-4221
Provider Business Mailing Address Fax Number:
573-336-4714

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
394 OLD ROUTE 66 STE 101
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAINT ROBERT
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
65584-3829
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
573-336-4221
Provider Business Practice Location Address Fax Number:
573-336-4714
Provider Enumeration Date:
10/11/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
TOWNSEND
Authorized Official First Name:
RICK
Authorized Official Middle Name:
L.
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
573-336-4221

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  006067 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 128392 . This is a "BC/BS" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 666734 . This is a "HEALTHLINK" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".