Provider Demographics
NPI:1700055548
Name:CHIROPRACTIC PAIN RELIEF CENTERS, P.C
Entity Type:Organization
Organization Name:CHIROPRACTIC PAIN RELIEF CENTERS, P.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:BAYS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:417-532-6251
Mailing Address - Street 1:212 VANCE ROAD
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:MO
Mailing Address - Zip Code:65536-3664
Mailing Address - Country:US
Mailing Address - Phone:417-532-6251
Mailing Address - Fax:417-532-6221
Practice Address - Street 1:212 VANCE ROAD
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:MO
Practice Address - Zip Code:65536-3664
Practice Address - Country:US
Practice Address - Phone:417-532-6251
Practice Address - Fax:417-532-6221
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-26
Last Update Date:2012-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO000014092Medicare PIN