Provider Demographics
NPI:1285755702
Name:PROACTIVE CHIROPRACTIC, P.C.
Entity type:Organization
Organization Name:PROACTIVE CHIROPRACTIC, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BARBRA
Authorized Official - Middle Name:ERIN
Authorized Official - Last Name:CATES
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:636-464-8360
Mailing Address - Street 1:3600 RICHARDSON SQUARE WAY
Mailing Address - Street 2:
Mailing Address - City:ARNOLD
Mailing Address - State:MO
Mailing Address - Zip Code:63010-6002
Mailing Address - Country:US
Mailing Address - Phone:636-464-8360
Mailing Address - Fax:636-464-2180
Practice Address - Street 1:3600 RICHARDSON SQUARE WAY
Practice Address - Street 2:
Practice Address - City:ARNOLD
Practice Address - State:MO
Practice Address - Zip Code:63010-6002
Practice Address - Country:US
Practice Address - Phone:636-464-8360
Practice Address - Fax:636-464-2180
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-02
Last Update Date:2008-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty