LAKE OF THE OZARKS LASER PAIN CENTER LLC (NPI# 1730605312) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730605312 |
| Entity Type | Organization |
| Organization Name | LAKE OF THE OZARKS LASER PAIN CENTER LLC |
| Other Organization Name | BACK TO LIFE LASER PAIN CENTER |
| Practice Address |
1039 E Us Highway 54 Ste 100 Camdenton MO 65020-6852 |
| Mailing Address |
Po Box 268 Camdenton MO 65020-0268 |
| Practice Telephone | 5738732755 |
| Practice Fax Number | 5738732756 |
| Mailing Telephone | 5738732755 |
| Mailing Fax Number | 5738732756 |
| Enumeration Date | 2017-08-16 |
| Last Update Date | 2019-02-13 |
| Authorized Official Name | RONALD EUGENE ADAMSON (PRESIDENT) |
| Authorized Official Telephone | 5735879046 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP3300X |
Clinic/Center Specialization: Pain |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Back To Life Laser Pain Center | Doing Business As Name - Organization |
| Street Address |
1039 E US HIGHWAY 54 STE 100 |
| City | CAMDENTON |
| State | MO |
| Zip Code | 65020-6852 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295383024 | Carinda Elynn Steele | Physical Therapy Assistant | 1930 N Business 5, Camdenton, MO 65020 | 2019-08-26 |
| 1831651660 | Erin Elisabeth Sluyter | Physician Assistant | 1652 North Business Route 5, Camdenton, MO 65020 | 2019-04-01 |
| 1922575125 | Serene Shores, LLC | Counselor | 75 Court Circle Se, Camdenton, MO 65020 | 2018-10-26 |
| 1902396591 | Audrey Dawn Sheppard | Counselor | 89 Mccrory Dr, Camdenton, MO 65020 | 2018-05-18 |
| 1427586072 | Abc Laurie LLC | Chiropractor | 139 E Hwy 54 Suite 1c, Camdenton, MO 65020 | 2017-05-26 |
| 1891229878 | Benton Street Counseling LLC | Counselor | 89 Mccrory Drive, Camdenton, MO 65020 | 2017-04-17 |
| 1033658463 | Erica L Asbell | Social Worker | 172 Dare Blvd., Camdenton, MO 65020 | 2017-02-17 |
| 1376816967 | Linda Susan Sheriff | Speech-Language Pathologist | 158 Minor Street, Camdenton, MO 65020 | 2012-02-14 |
| 1285902031 | Gregory Ryan Boren | Pharmacist | 72 South Business Route 5, Camdenton, MO 65020 | 2011-12-08 |
| 1265757033 | Abcs of Wellness, LLC | Chiropractor | 139 E. Hwy 54, 1c, Camdenton, MO 65020 | 2010-04-05 |
| Find all providers in zip 65020 | ||||
| Taxonomy Code | 261QP3300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Pain |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952799264 | James R. Cook, Md | Clinic/Center | 2333 E Glenwood St, Springfield, MO 65804-3320 | 2015-01-08 |
| 1841540382 | Elpis Healthcare Inc | Clinic/Center | 9918 Grandview Forest Ct, Saint Louis, MO 63127-0046 | 2012-09-12 |
| 1114944196 | Twin City Healt Services | Clinic/Center | 2310 N Truman Blvd, Crystal City, MO 63019-1037 | 2006-07-16 |
| 1649623240 | Integrative Spine Care LLC | Clinic/Center | 13710 Olive Blvd, Chesterfield, MO 63017-2602 | 2016-07-19 |
| 1730588674 | Midwest Health Solutions LLC | Clinic/Center | 24 Southtowne Dr, Potosi, MO 63664-5729 | 2014-08-16 |
| 1114290749 | South County Anesthesia Associates, Ltd | Clinic/Center | 1601 Wentzville Pkwy, Suite 109, Wentzville, MO 63385-3814 | 2012-02-13 |
| 1265705883 | South County Anesthesia Associates, Ltd | Clinic/Center | 4800 Mexico Rd, Suite 101, Saint Peters, MO 63376-1666 | 2012-02-13 |
| 1689947202 | South County Anesthesia Associates, Ltd | Clinic/Center | 1055 Bowles Ave, Suite 200, Fenton, MO 63026-2308 | 2012-02-13 |
| 1508909680 | Physician Groups Lc | Clinic/Center | 11155 Dunn Rd, Suite 109n, Saint Louis, MO 63136-6150 | 2007-02-15 |
| 1265545495 | Ch Allied Services, Inc. | Clinic/Center | 1600 E Broadway, Columbia, MO 65201-5844 | 2006-08-15 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.