Provider Demographics
NPI:1306003454
Name:BISCHOF CHIROPRACTIC AND FAMILY HEALTH CARE
Entity Type:Organization
Organization Name:BISCHOF CHIROPRACTIC AND FAMILY HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DIANN
Authorized Official - Middle Name:
Authorized Official - Last Name:BISCHOF
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:636-271-3600
Mailing Address - Street 1:220 N COLUMBUS ST
Mailing Address - Street 2:
Mailing Address - City:PACIFIC
Mailing Address - State:MO
Mailing Address - Zip Code:63069-1522
Mailing Address - Country:US
Mailing Address - Phone:636-271-3600
Mailing Address - Fax:636-257-3151
Practice Address - Street 1:220 N COLUMBUS ST
Practice Address - Street 2:
Practice Address - City:PACIFIC
Practice Address - State:MO
Practice Address - Zip Code:63069-1522
Practice Address - Country:US
Practice Address - Phone:636-271-3600
Practice Address - Fax:636-257-3151
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-16
Last Update Date:2008-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2004026180302F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO197367OtherANTHEM BLUE CROSS BLUE SHIELD
VO3836Medicare UPIN