Provider Demographics
NPI:1932537099
Name:DR REBECCA PEARSON LLC
Entity Type:Organization
Organization Name:DR REBECCA PEARSON LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/SOLE MBR
Authorized Official - Prefix:DR
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:L
Authorized Official - Last Name:PEARSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:417-337-7100
Mailing Address - Street 1:3000 GREEN MOUNTAIN DR
Mailing Address - Street 2:SUITE 107-355
Mailing Address - City:BRANSON
Mailing Address - State:MO
Mailing Address - Zip Code:65616-4011
Mailing Address - Country:US
Mailing Address - Phone:417-337-7100
Mailing Address - Fax:417-708-6415
Practice Address - Street 1:2404 HIGHWAY 248 STE 3
Practice Address - Street 2:
Practice Address - City:BRANSON
Practice Address - State:MO
Practice Address - Zip Code:65616-9627
Practice Address - Country:US
Practice Address - Phone:417-337-7100
Practice Address - Fax:417-336-3137
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-28
Last Update Date:2019-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty