Provider Demographics
NPI:1003097452
Name:COPELAND CHIROPRACTIC PC
Entity Type:Organization
Organization Name:COPELAND CHIROPRACTIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:S
Authorized Official - Last Name:COPELAND
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:636-386-6200
Mailing Address - Street 1:113 OLD STATE RD STE 202
Mailing Address - Street 2:
Mailing Address - City:ELLISVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:63021-2042
Mailing Address - Country:US
Mailing Address - Phone:636-386-6200
Mailing Address - Fax:636-386-8849
Practice Address - Street 1:113 OLD STATE RD STE 202
Practice Address - Street 2:
Practice Address - City:ELLISVILLE
Practice Address - State:MO
Practice Address - Zip Code:63021-2042
Practice Address - Country:US
Practice Address - Phone:636-386-6200
Practice Address - Fax:636-386-8849
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-14
Last Update Date:2007-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO005170111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty