Provider Demographics
NPI:1477723229
Name:MITCHELL CHIROPRACTIC AND REHABILITATION CENTER, LLC
Entity Type:Organization
Organization Name:MITCHELL CHIROPRACTIC AND REHABILITATION CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF CHIROPRACTIC
Authorized Official - Prefix:DR
Authorized Official - First Name:AMBER
Authorized Official - Middle Name:R
Authorized Official - Last Name:MITCHELL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:417-885-9078
Mailing Address - Street 1:1015 E REPUBLIC RD
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65807-6007
Mailing Address - Country:US
Mailing Address - Phone:417-885-9078
Mailing Address - Fax:417-885-9072
Practice Address - Street 1:1015 E REPUBLIC RD
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65807-6007
Practice Address - Country:US
Practice Address - Phone:417-885-9078
Practice Address - Fax:417-885-9072
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-07
Last Update Date:2008-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty