Provider Demographics
NPI:1235307505
Name:ALTERNATIVE HEALTH SERVICES PC
Entity Type:Organization
Organization Name:ALTERNATIVE HEALTH SERVICES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DC/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MERCEDES
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:WILLIAMSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:573-754-5350
Mailing Address - Street 1:3001 GEORGIA ST
Mailing Address - Street 2:
Mailing Address - City:LOUISIANA
Mailing Address - State:MO
Mailing Address - Zip Code:63353-2580
Mailing Address - Country:US
Mailing Address - Phone:573-754-5350
Mailing Address - Fax:
Practice Address - Street 1:3001 GEORGIA ST
Practice Address - Street 2:
Practice Address - City:LOUISIANA
Practice Address - State:MO
Practice Address - Zip Code:63353-2580
Practice Address - Country:US
Practice Address - Phone:573-754-5350
Practice Address - Fax:573-754-5227
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-20
Last Update Date:2013-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO006681111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO000014444Medicare PIN