Provider Demographics
NPI:1699170159
Name:GEOSLING CHIROPRACTIC CLINIC, INC
Entity type:Organization
Organization Name:GEOSLING CHIROPRACTIC CLINIC, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LEAMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:GEOSLING
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:417-823-8110
Mailing Address - Street 1:5503 S ROANOKE AVE
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65810-2723
Mailing Address - Country:US
Mailing Address - Phone:417-823-8110
Mailing Address - Fax:417-823-8101
Practice Address - Street 1:1200 E WOODHURST DR
Practice Address - Street 2:SUITE L200
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65804-4261
Practice Address - Country:US
Practice Address - Phone:417-823-8110
Practice Address - Fax:417-823-8101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-27
Last Update Date:2014-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO004613261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center