Provider Demographics
NPI:1912125006
Name:PLAZA CHIROPRACTIC AND ACUPUNCTURE, P.C.
Entity type:Organization
Organization Name:PLAZA CHIROPRACTIC AND ACUPUNCTURE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TERRI
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:MONAHAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC,NCCAOM,DIPLAC
Authorized Official - Phone:573-883-7177
Mailing Address - Street 1:PO BOX 271
Mailing Address - Street 2:
Mailing Address - City:STE GENEVIEVE
Mailing Address - State:MO
Mailing Address - Zip Code:63670-0271
Mailing Address - Country:US
Mailing Address - Phone:573-883-7177
Mailing Address - Fax:573-883-7469
Practice Address - Street 1:675 POINTE BASSE DR
Practice Address - Street 2:
Practice Address - City:STE GENEVIEVE
Practice Address - State:MO
Practice Address - Zip Code:63670-1850
Practice Address - Country:US
Practice Address - Phone:573-883-7177
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-23
Last Update Date:2008-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO61828OtherGHP
MO415969OtherHEALTHLINK
MO44-00132OtherUHC
MO4856OtherBLUE CROSS BLUE SHIELD