Provider Demographics
NPI:1124850102
Name:MARSHALL MO CHIROPRACTIC LLC
Entity type:Organization
Organization Name:MARSHALL MO CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:REMINGTON
Authorized Official - Middle Name:
Authorized Official - Last Name:SIEBERT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:660-886-7134
Mailing Address - Street 1:PO BOX 792
Mailing Address - Street 2:
Mailing Address - City:MARSHALL
Mailing Address - State:MO
Mailing Address - Zip Code:65340-0792
Mailing Address - Country:US
Mailing Address - Phone:660-886-7134
Mailing Address - Fax:660-886-7135
Practice Address - Street 1:754 S ODELL AVE
Practice Address - Street 2:
Practice Address - City:MARSHALL
Practice Address - State:MO
Practice Address - Zip Code:65340-2504
Practice Address - Country:US
Practice Address - Phone:660-886-7134
Practice Address - Fax:660-886-7135
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-17
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor