Provider Demographics
NPI:1750694519
Name:FAMILY FIRST CHIROPRACTIC AND WELLNESS CENTER
Entity type:Organization
Organization Name:FAMILY FIRST CHIROPRACTIC AND WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KELLI
Authorized Official - Middle Name:D
Authorized Official - Last Name:WINARSKI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:573-443-5900
Mailing Address - Street 1:2011 CORONA RD
Mailing Address - Street 2:STE 103
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65203-2548
Mailing Address - Country:US
Mailing Address - Phone:573-443-5900
Mailing Address - Fax:573-443-5901
Practice Address - Street 1:2011 CORONA RD
Practice Address - Street 2:STE 103
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65203-2548
Practice Address - Country:US
Practice Address - Phone:573-443-5900
Practice Address - Fax:573-443-5901
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-22
Last Update Date:2010-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2009036416111NP0017X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NP0017XChiropractic ProvidersChiropractorPediatric ChiropractorGroup - Single Specialty