Bent Back Chiropractic, LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2012030945 Issued in MO

Legal business name

BENT BACK CHIROPRACTIC, LLC

Practice address

220 Gravois Rd
Fenton, MO 63026-4129

Phone

(324) 223-5187

NPI assigned

Sep 4, 2012

Last updated

Jan 15, 2013By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Amber Bent, D.C.

Title

Owner

Phone

(314) 223-5187

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1346716800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1358208000000",
    "number": "1346599594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 KASSEBAUM LN",
            "address_2": "302",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631291789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 GRAVOIS RD",
            "city": "FENTON",
            "state": "MO",
            "postal_code": "630264129",
            "telephone_number": "324-223-5187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BENT BACK CHIROPRACTIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-04",
        "last_updated": "2013-01-15",
        "status": "A",
        "authorized_official_last_name": "BENT",
        "authorized_official_first_name": "AMBER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "314-223-5187",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2012030945",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Fenton, MO
• Providers in Fenton, MO by specialty
• Chiropractor in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.