Provider Demographics
NPI:1225135247
Name:ROMA J TURNER DC LLC
Entity Type:Organization
Organization Name:ROMA J TURNER DC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROMA
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:TURNER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:417-831-5522
Mailing Address - Street 1:2810 W LATOKA ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65807-2150
Mailing Address - Country:US
Mailing Address - Phone:417-877-1736
Mailing Address - Fax:417-831-5522
Practice Address - Street 1:1908 E SUNSHINE ST
Practice Address - Street 2:SUITE D
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65804-1504
Practice Address - Country:US
Practice Address - Phone:417-831-5522
Practice Address - Fax:417-831-5522
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO004250111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOA12902Medicare UPIN
MO32126Medicare ID - Type Unspecified