Organization
ADVANCED ALTERNATIVE HEALTHCARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDWARD R DOUGLAS DO (OWNER)
(417) 890-5585
Entity
Organization
Contact information
Practice address
3829 S JEFFERSON AVE, SPRINGFIELD, MO 65807-5376
(417) 890-5585
(417) 877-0970
Mailing address
3829 S JEFFERSON AVE, SPRINGFIELD, MO 65807-5376
(417) 890-5585
(417) 877-0970
Taxonomy
Speciality
Code
Description
License number
State
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
Primary
2002013903
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500940903
—
MO
Enumeration date
01/15/2007
Last updated
04/23/2011
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