Provider Demographics
NPI:1235910845
Name:CMC CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:CMC CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ASTON
Authorized Official - Middle Name:
Authorized Official - Last Name:GOLDSWORTHY
Authorized Official - Suffix:
Authorized Official - Credentials:DC, MSN, BC-FNP
Authorized Official - Phone:816-674-2693
Mailing Address - Street 1:1131 W MAIN ST STE G
Mailing Address - Street 2:
Mailing Address - City:BLUE SPRINGS
Mailing Address - State:MO
Mailing Address - Zip Code:64015-3611
Mailing Address - Country:US
Mailing Address - Phone:816-674-2693
Mailing Address - Fax:816-229-7085
Practice Address - Street 1:1131 W MAIN ST STE G
Practice Address - Street 2:
Practice Address - City:BLUE SPRINGS
Practice Address - State:MO
Practice Address - Zip Code:64015-3611
Practice Address - Country:US
Practice Address - Phone:816-674-2693
Practice Address - Fax:816-229-7085
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-10
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No111NI0013XChiropractic ProvidersChiropractorIndependent Medical ExaminerGroup - Multi-Specialty
No111NN0400XChiropractic ProvidersChiropractorNeurologyGroup - Multi-Specialty
No111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Multi-Specialty
No111NX0100XChiropractic ProvidersChiropractorOccupational HealthGroup - Multi-Specialty
No111NX0800XChiropractic ProvidersChiropractorOrthopedicGroup - Multi-Specialty