Provider Demographics
NPI:1477857183
Name:ABLE CHIROPRACTIC ARTS, PC
Entity Type:Organization
Organization Name:ABLE CHIROPRACTIC ARTS, PC
Other - Org Name:CHIROPRACTIC BY MCKELLAR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:TERRENCE
Authorized Official - Middle Name:KEITH
Authorized Official - Last Name:MCKELLAR
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:636-947-4046
Mailing Address - Street 1:1000 FAIRGROUNDS RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SAINT CHARLES
Mailing Address - State:MO
Mailing Address - Zip Code:63301-2381
Mailing Address - Country:US
Mailing Address - Phone:636-947-4046
Mailing Address - Fax:
Practice Address - Street 1:1000 FAIRGROUNDS RD
Practice Address - Street 2:SUITE 101
Practice Address - City:SAINT CHARLES
Practice Address - State:MO
Practice Address - Zip Code:63301-2381
Practice Address - Country:US
Practice Address - Phone:636-947-4046
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-10
Last Update Date:2011-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO004887261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO000030030Medicare PIN