| NPI | 1821217654 |
|---|---|
| Other Name | RENUVA BACK AND PAIN CENTERS |
| Entity Type | Organization |
| Authorized Contact | MICHAEL DAVID RILEY Owner 417-781-3472 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: MO 2010010250) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: KS 01-4728) |
| Enumeration Date | 2007-04-24 |
| Last Update Date | 2020-05-21 |