Provider Demographics
NPI:1083167431
Name:WOMEN'S NATURAL HORMONE CLINIC
Entity Type:Organization
Organization Name:WOMEN'S NATURAL HORMONE CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:APRIL
Authorized Official - Middle Name:FRERKIGN
Authorized Official - Last Name:RADATZ
Authorized Official - Suffix:
Authorized Official - Credentials:DAOM
Authorized Official - Phone:417-334-0899
Mailing Address - Street 1:500 W MAIN ST
Mailing Address - Street 2:SUITE 403
Mailing Address - City:BRANSON
Mailing Address - State:MO
Mailing Address - Zip Code:65616-2727
Mailing Address - Country:US
Mailing Address - Phone:417-334-0899
Mailing Address - Fax:417-239-1700
Practice Address - Street 1:500 W MAIN ST
Practice Address - Street 2:SUITE 403
Practice Address - City:BRANSON
Practice Address - State:MO
Practice Address - Zip Code:65616-2727
Practice Address - Country:US
Practice Address - Phone:417-334-0899
Practice Address - Fax:417-239-1700
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-02
Last Update Date:2016-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2009005984111N00000X
MO2012023704171100000X
MO2012023705171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty