Provider Demographics
NPI:1306142930
Name:PARSONS CHIROPRACTIC SPORTS MEDICINE
Entity type:Organization
Organization Name:PARSONS CHIROPRACTIC SPORTS MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:G
Authorized Official - Last Name:PARSONS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:913-744-9271
Mailing Address - Street 1:PO BOX 162
Mailing Address - Street 2:
Mailing Address - City:PECULIAR
Mailing Address - State:MO
Mailing Address - Zip Code:64078-0162
Mailing Address - Country:US
Mailing Address - Phone:913-744-9271
Mailing Address - Fax:
Practice Address - Street 1:124 W NORTH ST
Practice Address - Street 2:
Practice Address - City:PECULIAR
Practice Address - State:MO
Practice Address - Zip Code:64078-9422
Practice Address - Country:US
Practice Address - Phone:913-744-9271
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-29
Last Update Date:2013-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2008028719111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Single Specialty