Provider Demographics
NPI:1790906709
Name:NIXA FAMILY CHIROPRACTIC INC
Entity Type:Organization
Organization Name:NIXA FAMILY CHIROPRACTIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:K
Authorized Official - Last Name:SHANKS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:417-725-8550
Mailing Address - Street 1:813 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NIXA
Mailing Address - State:MO
Mailing Address - Zip Code:65714-9315
Mailing Address - Country:US
Mailing Address - Phone:417-725-8550
Mailing Address - Fax:417-725-8553
Practice Address - Street 1:813 N MAIN ST
Practice Address - Street 2:
Practice Address - City:NIXA
Practice Address - State:MO
Practice Address - Zip Code:65714-9315
Practice Address - Country:US
Practice Address - Phone:417-725-8550
Practice Address - Fax:417-725-8553
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2004008978111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty