Provider Demographics
NPI:1548411051
Name:THERAPEUTIC EXERCISE AND CHIROPRACTIC CORPORATION
Entity Type:Organization
Organization Name:THERAPEUTIC EXERCISE AND CHIROPRACTIC CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SAMANTHA
Authorized Official - Middle Name:
Authorized Official - Last Name:KINSLOW
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:816-812-8260
Mailing Address - Street 1:208 WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:MO
Mailing Address - Zip Code:64098-1330
Mailing Address - Country:US
Mailing Address - Phone:816-812-8262
Mailing Address - Fax:816-386-9911
Practice Address - Street 1:18215 NORTH HWY 45
Practice Address - Street 2:SUITE C
Practice Address - City:WESTON
Practice Address - State:MO
Practice Address - Zip Code:64098
Practice Address - Country:US
Practice Address - Phone:816-812-8262
Practice Address - Fax:816-386-9911
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-02
Last Update Date:2009-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO119374261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy