Provider Demographics
NPI:1700934379
Name:CORRECTIVE CHIROPRACTIC PC
Entity Type:Organization
Organization Name:CORRECTIVE CHIROPRACTIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEWS
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:SORELL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:816-224-9355
Mailing Address - Street 1:1901 NW STATE ROUTE 7
Mailing Address - Street 2:STE. B
Mailing Address - City:BLUE SPRINGS
Mailing Address - State:MO
Mailing Address - Zip Code:64014
Mailing Address - Country:US
Mailing Address - Phone:816-224-9355
Mailing Address - Fax:816-817-1119
Practice Address - Street 1:1901 NW STATE ROUTE 7
Practice Address - Street 2:STE. B
Practice Address - City:BLUE SPRINGS
Practice Address - State:MO
Practice Address - Zip Code:64014
Practice Address - Country:US
Practice Address - Phone:816-224-9355
Practice Address - Fax:816-817-1119
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2005021387111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1659488260OtherPERSONAL NPI NUMBER