# ADVANCED ALTERNATIVE HEALTHCARE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1457402752
- **Authorized official:** DR. EDWARD R DOUGLAS DO (OWNER)
- **Authorized official phone:** (417) 890-5585

## Contact information

- **Practice address:** 3829 S JEFFERSON AVE, SPRINGFIELD, MO 65807-5376
- **Practice address phone:** (417) 890-5585
- **Practice address fax:** (417) 877-0970
- **Mailing address:** 3829 S JEFFERSON AVE, SPRINGFIELD, MO 65807-5376
- **Mailing address phone:** (417) 890-5585
- **Mailing address fax:** (417) 877-0970

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 204D00000X | Neuromusculoskeletal Medicine & OMM Physician | 2002013903 | MO | Yes |

## Other

- **Enumeration date:** 01/15/2007
- **Last updated:** 04/23/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 500940903 | — | MO |