Provider Demographics
NPI:1114496049
Name:RAMOS, ANDREW (DC, CACCP)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:
Last Name:RAMOS
Suffix:
Gender:M
Credentials:DC, CACCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 483
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65704-0483
Mailing Address - Country:US
Mailing Address - Phone:417-554-4176
Mailing Address - Fax:
Practice Address - Street 1:106 E PARK SQ STE A
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:MO
Practice Address - Zip Code:65704-8551
Practice Address - Country:US
Practice Address - Phone:417-554-2663
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-20
Last Update Date:2022-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2021046665111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty