Provider Demographics
NPI:1699186320
Name:HEALTH CENTERS OF MISSOURI, LLC
Entity Type:Organization
Organization Name:HEALTH CENTERS OF MISSOURI, LLC
Other - Org Name:HEALTH CENTERS OF THE OZARKS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ORGANIZER
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:E
Authorized Official - Last Name:WURST
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:417-338-9355
Mailing Address - Street 1:1232 BRANSON HILLS PKWY STE 202
Mailing Address - Street 2:
Mailing Address - City:BRANSON
Mailing Address - State:MO
Mailing Address - Zip Code:65616-4188
Mailing Address - Country:US
Mailing Address - Phone:417-338-9355
Mailing Address - Fax:
Practice Address - Street 1:1232 BRANSON HILLS PKWY STE 202
Practice Address - Street 2:
Practice Address - City:BRANSON
Practice Address - State:MO
Practice Address - Zip Code:65616-4188
Practice Address - Country:US
Practice Address - Phone:417-338-9355
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-15
Last Update Date:2014-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty