Provider Demographics
NPI:1275716821
Name:WORDEN, JOSEPH DONALD III (DC)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:DONALD
Last Name:WORDEN
Suffix:III
Gender:M
Credentials:DC
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 306
Mailing Address - Street 2:
Mailing Address - City:PILOT KNOB
Mailing Address - State:MO
Mailing Address - Zip Code:63663-0306
Mailing Address - Country:US
Mailing Address - Phone:573-546-0882
Mailing Address - Fax:573-546-7812
Practice Address - Street 1:305 NORTH HIGHWAY 21
Practice Address - Street 2:
Practice Address - City:PILOT KNOB
Practice Address - State:MO
Practice Address - Zip Code:63663-0306
Practice Address - Country:US
Practice Address - Phone:573-546-0882
Practice Address - Fax:573-546-7812
Is Sole Proprietor?:No
Enumeration Date:2007-12-06
Last Update Date:2007-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2007023074111N00000X, 111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NN1001XChiropractic ProvidersChiropractorNutrition