Provider Demographics
NPI:1679263842
Name:AXIS CHIROPRACTIC LLC
Entity type:Organization
Organization Name:AXIS CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:SOMMER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:660-373-2280
Mailing Address - Street 1:17006 HIGHWAY 87 STE B
Mailing Address - Street 2:
Mailing Address - City:BOONVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:65233-2938
Mailing Address - Country:US
Mailing Address - Phone:660-373-2280
Mailing Address - Fax:
Practice Address - Street 1:17006 HIGHWAY 87 STE B
Practice Address - Street 2:
Practice Address - City:BOONVILLE
Practice Address - State:MO
Practice Address - Zip Code:65233-2938
Practice Address - Country:US
Practice Address - Phone:660-373-2280
Practice Address - Fax:660-202-1875
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-11
Last Update Date:2023-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty