Provider Demographics
NPI:1801001060
Name:BUCHHEIT CHIROPRACTIC, P.C.
Entity Type:Organization
Organization Name:BUCHHEIT CHIROPRACTIC, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:DARYL
Authorized Official - Middle Name:RAY
Authorized Official - Last Name:BUCHHEIT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:573-517-0696
Mailing Address - Street 1:PO BOX 331
Mailing Address - Street 2:
Mailing Address - City:PERRYVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:63775-0331
Mailing Address - Country:US
Mailing Address - Phone:573-517-0696
Mailing Address - Fax:573-517-0844
Practice Address - Street 1:707 N MAIN ST
Practice Address - Street 2:
Practice Address - City:PERRYVILLE
Practice Address - State:MO
Practice Address - Zip Code:63775-1303
Practice Address - Country:US
Practice Address - Phone:573-517-0696
Practice Address - Fax:573-517-0844
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-11
Last Update Date:2007-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO006562111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO000015385Medicare PIN