Provider Demographics
NPI:1790984516
Name:CARY BANEY
Entity Type:Organization
Organization Name:CARY BANEY
Other - Org Name:COUNTY CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CARY
Authorized Official - Middle Name:
Authorized Official - Last Name:BANEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:573-564-3600
Mailing Address - Street 1:108 W 2ND ST
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY CITY
Mailing Address - State:MO
Mailing Address - Zip Code:63361-1813
Mailing Address - Country:US
Mailing Address - Phone:573-564-3600
Mailing Address - Fax:573-564-3600
Practice Address - Street 1:108 W 2ND ST
Practice Address - Street 2:
Practice Address - City:MONTGOMERY CITY
Practice Address - State:MO
Practice Address - Zip Code:63361-1813
Practice Address - Country:US
Practice Address - Phone:573-564-3600
Practice Address - Fax:573-564-3600
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-12
Last Update Date:2012-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2001012377111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO143494OtherBLUE CROSS MISSOUR
MO1497757280OtherINDIVIDUAL NPI #
MO466683OtherHEALTHLINK
MO629911OtherACN
MO143494OtherBLUE CROSS MISSOUR
MO629911OtherACN