| Organization Name: | CHIROPRACTIC CONNECTION LLC |
| NPI Number: | 1548491269 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | RYAN JOSEPH TISHER (OWNER) |
| Mailing Address: | 535 Rozier St Ste Genevieve |
| State: | MO US |
| Postal Code: | 636701557 |
| Phone Number: | 5738836102 |
| Fax Number: | |
| NPI Enumeration Date: | 07/29/2009 |
| NPI Last Update Date: | 07/29/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QH0100X |
| License Number: | 2003010149 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MO |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Health Service |
| Taxonomy Definition: | |