417 Performance Chiro LLC
Organization Active NPI Chiropractor · Springfield, MO
NPI 1770326480 · NPPES record last updated Jun 18, 2024
Key facts
- NPI
- 1770326480
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Chiropractor 111N00000X
- Legal business name
- 417 PERFORMANCE CHIRO LLC
- Practice address
- 4728 S Campbell Ave Ste 132
Springfield, MO 65810-1715 - Phone
- (417) 597-3777
- NPI assigned
- Jun 18, 2024
- Organization subpart
- No
Authorized official
- Name
- Dr. Anthony C Bolin II, DC
- Title
- Director/Doctor
- Phone
- (417) 425-2759
Practitioners 1
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | Yes |
Addresses
Primary practice location
4728 S Campbell Ave Ste 132
Springfield, MO 65810-1715
Mailing address
4728 S Campbell Ave Ste 132
Springfield, MO 65810-1715
Phone (417) 597-3777
Other providers in Springfield, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 18, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.