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Individual

NASH ELIJAH SMALLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
517 COY BLVD, FORSYTH, MO 65653-5083
(417) 546-2411
(417) 546-2730
Mailing address
PO BOX 99, FORSYTH, MO 65653-0099
(660) 679-1433
(417) 546-2730

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2020031366
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2020031366
LICENSE
MO
Enumeration date
09/22/2020
Last updated
09/22/2020
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