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Organization
PURE VICTORY, LLC
Active
Organization
PURE VICTORY, LLC
Active
Other names
Victory Chiropractic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BOAZ L BANDY DC (DOCTOR OF CHIROPRACTIC)
(417) 337-7077
Entity
Organization
Contact information
Practice address
800 STATE HWY 248, SUITE 2-B, BRANSON, MO 65616
(417) 337-7077
Mailing address
800 STATE HWY 248, SUITE 2-B, BRANSON, MO 65616
(417) 337-7077
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2009032450
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1265755227
NPI TYPE I
MO
Enumeration date
03/15/2010
Last updated
07/24/2012
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