Provider Demographics
NPI:1639344146
Name:EL DORADO SPRINGS FAMILY CHIROPRACTIC, LLC
Entity Type:Organization
Organization Name:EL DORADO SPRINGS FAMILY CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NEIL
Authorized Official - Middle Name:
Authorized Official - Last Name:LINSENMAYER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:417-876-0541
Mailing Address - Street 1:605 E HOSPITAL RD STE 3
Mailing Address - Street 2:
Mailing Address - City:EL DORADO SPRINGS
Mailing Address - State:MO
Mailing Address - Zip Code:64744-2028
Mailing Address - Country:US
Mailing Address - Phone:417-876-0541
Mailing Address - Fax:417-876-5926
Practice Address - Street 1:605 E HOSPITAL RD STE 3
Practice Address - Street 2:
Practice Address - City:EL DORADO SPRINGS
Practice Address - State:MO
Practice Address - Zip Code:64744-2028
Practice Address - Country:US
Practice Address - Phone:417-876-0541
Practice Address - Fax:417-876-5926
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-25
Last Update Date:2008-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2000144180111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty