Provider Demographics
NPI:1619227436
Name:AMUNDSON CHIROPRACTIC HEALTH SERVICES LLC
Entity Type:Organization
Organization Name:AMUNDSON CHIROPRACTIC HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:AMUNDSON-MULLINS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:816-220-0660
Mailing Address - Street 1:104 N 7 HWY STE G
Mailing Address - Street 2:
Mailing Address - City:BLUE SPRINGS
Mailing Address - State:MO
Mailing Address - Zip Code:64014-2749
Mailing Address - Country:US
Mailing Address - Phone:816-220-0660
Mailing Address - Fax:
Practice Address - Street 1:104 N 7 HWY STE G
Practice Address - Street 2:
Practice Address - City:BLUE SPRINGS
Practice Address - State:MO
Practice Address - Zip Code:64014-2749
Practice Address - Country:US
Practice Address - Phone:816-220-0660
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-19
Last Update Date:2012-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty