Provider Demographics
NPI:1467281170
Name:CCM PROPERTIES
Entity type:Organization
Organization Name:CCM PROPERTIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRACTITIONER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:A
Authorized Official - Last Name:MAURER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:417-720-1250
Mailing Address - Street 1:2725 N KANSAS EXPY STE 104
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65803-1169
Mailing Address - Country:US
Mailing Address - Phone:417-720-1250
Mailing Address - Fax:417-720-1251
Practice Address - Street 1:2725 N KANSAS EXPY STE 104
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65803-1169
Practice Address - Country:US
Practice Address - Phone:417-720-1250
Practice Address - Fax:417-720-1251
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-31
Last Update Date:2024-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty