Provider Demographics
NPI:1063539773
Name:ESSMYER, MICHAEL CHRISTOPHER (DC)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:CHRISTOPHER
Last Name:ESSMYER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 565
Mailing Address - Street 2:
Mailing Address - City:POTOSI
Mailing Address - State:MO
Mailing Address - Zip Code:63664-0565
Mailing Address - Country:US
Mailing Address - Phone:573-431-1550
Mailing Address - Fax:573-431-6991
Practice Address - Street 1:311 N STATE ST
Practice Address - Street 2:
Practice Address - City:DESLOGE
Practice Address - State:MO
Practice Address - Zip Code:63601-3051
Practice Address - Country:US
Practice Address - Phone:573-431-1550
Practice Address - Fax:573-431-6991
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2020-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2003030306111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO194205OtherBLUE CROSS BLUE SHIELD
MO666018OtherUNITED HEALTHCARE
MO693960OtherHEALTHLINK