| NPI | 1982072104 |
|---|---|
| Former Legal Business Name | TRI LAKES CHIROSPORT, LLC |
| Entity Type | Organization |
| Authorized Contact | TIMOTHY JOSEPH ST. ONGE Owner 417-598-0080 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: MO 2015020074) |
| Enumeration Date | 2015-09-03 |
| Last Update Date | 2022-07-21 |