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Organization
PRO ACTIVE CHIROPRACTIC CENTER PC
Active
Organization
PRO ACTIVE CHIROPRACTIC CENTER PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN SCOTT STIFFEY D.C. (PRESIDENT)
(573) 769-2400
Entity
Organization
Contact information
Practice address
219 S MAIN ST, PALMYRA, MO 63461-1649
(573) 769-2400
(573) 769-0600
Mailing address
219 S MAIN ST, PALMYRA, MO 63461-1649
(573) 769-2400
(573) 769-0600
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2002004526
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000014883
MEDICARE GROUP
MO
Enumeration date
10/26/2007
Last updated
02/26/2025
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