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Organization

SPORT AND SPINE CHIROPRACTIC CENTER LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. GINGER LEAH SHARP D.C. (CFO)
(636) 456-2966
Entity
Organization

Contact information

Practice address
810 E HIGHWAY M, WARRENTON, MO 63383-2215
(636) 456-2966
(636) 456-2977
Mailing address
810 E HIGHWAY M, WARRENTON, MO 63383-2215
(636) 456-2966
(636) 456-2977

Taxonomy

Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
2006030811
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1699975995
INDIVIDUAL NPI (JOSHUA D. SHARP, D.C.)
MO
01
1730253659
INDIVIDUAL NPI (GINGER SHARP, D.C.)
MO
Enumeration date
06/07/2010
Last updated
06/07/2010
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