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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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