Provider Demographics
NPI:1841234143
Name:PREMIER HEALTH CARE, L.L.C.
Entity Type:Organization
Organization Name:PREMIER HEALTH CARE, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:KELLY
Authorized Official - Last Name:BRANHAM
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:314-647-1384
Mailing Address - Street 1:7411 MANCHESTER RD
Mailing Address - Street 2:
Mailing Address - City:MAPLEWOOD
Mailing Address - State:MO
Mailing Address - Zip Code:63143-3031
Mailing Address - Country:US
Mailing Address - Phone:314-647-1384
Mailing Address - Fax:314-781-1374
Practice Address - Street 1:7411 MANCHESTER RD
Practice Address - Street 2:
Practice Address - City:MAPLEWOOD
Practice Address - State:MO
Practice Address - Zip Code:63143-3031
Practice Address - Country:US
Practice Address - Phone:314-647-1384
Practice Address - Fax:314-781-1374
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO006575111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PENDINGMedicare ID - Type Unspecified