Provider Demographics
NPI:1013124866
Name:BEVIER FAMILY CHIROPRACTIC CLINIC LLC
Entity Type:Organization
Organization Name:BEVIER FAMILY CHIROPRACTIC CLINIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:ALBERT
Authorized Official - Last Name:FIQUET
Authorized Official - Suffix:III
Authorized Official - Credentials:DC, RN
Authorized Official - Phone:660-773-6777
Mailing Address - Street 1:206 N MACON ST
Mailing Address - Street 2:
Mailing Address - City:BEVIER
Mailing Address - State:MO
Mailing Address - Zip Code:63532-1059
Mailing Address - Country:US
Mailing Address - Phone:660-773-6777
Mailing Address - Fax:
Practice Address - Street 1:206 N MACON ST
Practice Address - Street 2:
Practice Address - City:BEVIER
Practice Address - State:MO
Practice Address - Zip Code:63532-1059
Practice Address - Country:US
Practice Address - Phone:660-773-6777
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO006323111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NN0400XChiropractic ProvidersChiropractorNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1336123082OtherNPI TYPE 1
MO00018470OtherNHC HEALTH BENEFIT PLAN
MO1862081OtherCOVENTRY
MOP261666OtherHEALTHLINK
MOP4400469OtherUNITED HEALTH CARE
MOH261666OtherHEALTH LINK HMO
MO141086OtherBC BS
MO1862081OtherCOVENTRY