Provider Demographics
NPI:1033658752
Name:ARMSTRONG SPINE AND SPORT
Entity Type:Organization
Organization Name:ARMSTRONG SPINE AND SPORT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTIC PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ISAAC
Authorized Official - Middle Name:CHRISTIAN
Authorized Official - Last Name:ARMSTRONG
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:573-701-0770
Mailing Address - Street 1:160 WESTMOUNT DR
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:MO
Mailing Address - Zip Code:63640-2970
Mailing Address - Country:US
Mailing Address - Phone:573-701-0770
Mailing Address - Fax:
Practice Address - Street 1:160 WESTMOUNT DR
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:MO
Practice Address - Zip Code:63640-2970
Practice Address - Country:US
Practice Address - Phone:573-701-0770
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-14
Last Update Date:2017-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2017003505111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty