Provider Demographics
NPI:1669634325
Name:CITIZEN'S CHIROPRACTIC CENTER LLC
Entity Type:Organization
Organization Name:CITIZEN'S CHIROPRACTIC CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:D
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:573-701-0770
Mailing Address - Street 1:160 WESTMOUT DR
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:MO
Mailing Address - Zip Code:63640-7474
Mailing Address - Country:US
Mailing Address - Phone:573-701-0770
Mailing Address - Fax:573-701-0771
Practice Address - Street 1:160 WESTMOUT DR
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:MO
Practice Address - Zip Code:63640-7474
Practice Address - Country:US
Practice Address - Phone:573-701-0770
Practice Address - Fax:573-701-0771
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-25
Last Update Date:2010-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
111N00000X
MOCE005186261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty