| Davis Chiropractic Center LLC | |
|
819 W 5th St Washington MO 63090-1923 | |
| (636) 239-4454 | |
| Not Available |
| Full Name | Davis Chiropractic Center LLC |
|---|---|
| Speciality | Clinic/Center |
| Location | 819 W 5th St, Washington, Missouri |
| Authorized Official Name and Position | Justin Davis (OWNER) |
| Authorized Official Contact | 6362394454 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Davis Chiropractic Center LLC 819 W 5th St Washington MO 63090-1923 Ph: (636) 239-4454 | Davis Chiropractic Center LLC 819 W 5th St Washington MO 63090-1923 Ph: (636) 239-4454 |
| NPI Number | 1619263480 |
|---|---|
| Provider Enumeration Date | 06/21/2011 |
| Last Update Date | 06/21/2011 |
| Medicare PECOS PAC ID | 5991937161 |
|---|---|
| Medicare Enrollment ID | O20140423000198 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619263480 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 2011017579 (Missouri) | Primary |
| Provider Name | Justin D Davis |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1134415995 PECOS PAC ID: 6800028077 Enrollment ID: I20140423000305 |
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