Provider Demographics
NPI:1871765669
Name:WORDEN CHIROPRACTIC AND HEALTH
Entity type:Organization
Organization Name:WORDEN CHIROPRACTIC AND HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:DONALD
Authorized Official - Last Name:WORDEN
Authorized Official - Suffix:III
Authorized Official - Credentials:DC
Authorized Official - Phone:573-546-0882
Mailing Address - Street 1:P.O. BOX 306
Mailing Address - Street 2:305 N HWY 21
Mailing Address - City:PILOT KNOB
Mailing Address - State:MO
Mailing Address - Zip Code:63663-0306
Mailing Address - Country:US
Mailing Address - Phone:573-546-0882
Mailing Address - Fax:573-546-7812
Practice Address - Street 1:305 N HWY 21
Practice Address - Street 2:
Practice Address - City:PILOT KNOB
Practice Address - State:MO
Practice Address - Zip Code:63663-0306
Practice Address - Country:US
Practice Address - Phone:573-546-0882
Practice Address - Fax:573-546-7812
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-01
Last Update Date:2008-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2007023074111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NN1001XChiropractic ProvidersChiropractorNutritionGroup - Single Specialty