Provider Demographics
NPI:1790862654
Name:CHIROPRACTIC HEALTHCARE PLUS, PC
Entity Type:Organization
Organization Name:CHIROPRACTIC HEALTHCARE PLUS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DIMITRIOS
Authorized Official - Middle Name:M
Authorized Official - Last Name:THEOHARIDIS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:816-429-6598
Mailing Address - Street 1:601 S STATE ROUTE 291 STE B
Mailing Address - Street 2:
Mailing Address - City:LIBERTY
Mailing Address - State:MO
Mailing Address - Zip Code:64068-1958
Mailing Address - Country:US
Mailing Address - Phone:816-429-6598
Mailing Address - Fax:816-429-8471
Practice Address - Street 1:601 S STATE ROUTE 291 STE B
Practice Address - Street 2:
Practice Address - City:LIBERTY
Practice Address - State:MO
Practice Address - Zip Code:64068-1958
Practice Address - Country:US
Practice Address - Phone:816-429-6598
Practice Address - Fax:816-429-8471
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-31
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO006774111N00000X
NYX009322111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYAA1090Medicare ID - Type UnspecifiedGROUP NUMBER