Provider Demographics
NPI:1063699726
Name:STEINBRUECK CHIROPRACTIC HEALTH CENTER, LLC
Entity type:Organization
Organization Name:STEINBRUECK CHIROPRACTIC HEALTH CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:RANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:STEINBRUECK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:573-769-3308
Mailing Address - Street 1:322 W ROSS ST
Mailing Address - Street 2:
Mailing Address - City:PALMYRA
Mailing Address - State:MO
Mailing Address - Zip Code:63461-1420
Mailing Address - Country:US
Mailing Address - Phone:573-769-3308
Mailing Address - Fax:573-769-2061
Practice Address - Street 1:322 W ROSS ST
Practice Address - Street 2:
Practice Address - City:PALMYRA
Practice Address - State:MO
Practice Address - Zip Code:63461-1420
Practice Address - Country:US
Practice Address - Phone:573-769-3308
Practice Address - Fax:573-769-2061
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-24
Last Update Date:2024-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO004710111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO000014393Medicare PIN