Organization
WELLNESS CONCEPTS CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ERIC WAYNE REAVIS DC (MEDICAL DIRECTOR)
(417) 877-1300
Entity
Organization
Contact information
Practice address
1200 E WOODHURST DR, STE R 300, SPRINGFIELD, MO 65804-4261
(417) 877-1300
(417) 877-1335
Mailing address
1200 E WOODHURST DR, STE R 300, SPRINGFIELD, MO 65804-4261
(417) 877-1300
(417) 877-1335
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
2003027886
MO
111NS0005X
Sports Physician Chiropractor
Primary
2007008411
MO
171100000X
Acupuncturist
2002024850
MO
171100000X
Acupuncturist
2002030343
MO
Other
Enumeration date
01/23/2009
Last updated
01/23/2009
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