Provider Demographics
NPI:1063689685
Name:RAGAIN CHIROPRACTIC CLINIC PC
Entity Type:Organization
Organization Name:RAGAIN CHIROPRACTIC CLINIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:RAGAIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:573-374-7660
Mailing Address - Street 1:PO BOX 1195
Mailing Address - Street 2:
Mailing Address - City:LAURIE
Mailing Address - State:MO
Mailing Address - Zip Code:65038-1195
Mailing Address - Country:US
Mailing Address - Phone:573-374-7660
Mailing Address - Fax:573-374-7660
Practice Address - Street 1:409 NORTH MAIN
Practice Address - Street 2:
Practice Address - City:LAURIE
Practice Address - State:MO
Practice Address - Zip Code:65038
Practice Address - Country:US
Practice Address - Phone:573-374-7660
Practice Address - Fax:573-374-7660
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-13
Last Update Date:2008-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOCE004532111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1952527129Medicare PIN