Provider Demographics
NPI:1124659180
Name:ELDON FAMILY CHIROPRACTIC, LLC
Entity type:Organization
Organization Name:ELDON FAMILY CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:MEGAN
Authorized Official - Middle Name:RENE
Authorized Official - Last Name:PORTER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:573-286-2638
Mailing Address - Street 1:PO BOX 8
Mailing Address - Street 2:
Mailing Address - City:HIGH POINT
Mailing Address - State:MO
Mailing Address - Zip Code:65042-0008
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:102 N BUSINESS HIGHWAY 54 E STE D
Practice Address - Street 2:
Practice Address - City:ELDON
Practice Address - State:MO
Practice Address - Zip Code:65026-2041
Practice Address - Country:US
Practice Address - Phone:573-286-2638
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-29
Last Update Date:2020-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center