Provider Demographics
NPI:1578681565
Name:ESSEN CHIROPRACTIC AND ACUPUNCTURE, L L C
Entity Type:Organization
Organization Name:ESSEN CHIROPRACTIC AND ACUPUNCTURE, L L C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOAN
Authorized Official - Middle Name:E
Authorized Official - Last Name:ESSEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:636-825-0360
Mailing Address - Street 1:11770 MANCHESTER ROAD
Mailing Address - Street 2:
Mailing Address - City:DES PERES
Mailing Address - State:MO
Mailing Address - Zip Code:63131-9998
Mailing Address - Country:US
Mailing Address - Phone:636-825-0360
Mailing Address - Fax:636-825-0360
Practice Address - Street 1:11770 MANCHESTER ROAD
Practice Address - Street 2:
Practice Address - City:DES PERES
Practice Address - State:MO
Practice Address - Zip Code:63131-9998
Practice Address - Country:US
Practice Address - Phone:636-825-0360
Practice Address - Fax:636-825-0360
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-27
Last Update Date:2015-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2001011183111N00000X, 171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO144594OtherANTHEM BCBS
MO627977OtherUHC
MO144594OtherANTHEM BCBS