Provider Demographics
NPI:1730257775
Name:ROBERTS, RANEE FURROW (DC)
Entity type:Individual
Prefix:DR
First Name:RANEE
Middle Name:FURROW
Last Name:ROBERTS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:RANEE
Other - Middle Name:FURROW
Other - Last Name:KING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:5003 US HIGHWAY 160
Mailing Address - Street 2:
Mailing Address - City:WEST PLAINS
Mailing Address - State:MO
Mailing Address - Zip Code:65775-7665
Mailing Address - Country:US
Mailing Address - Phone:417-255-8302
Mailing Address - Fax:417-255-8389
Practice Address - Street 1:5003 US HIGHWAY 160
Practice Address - Street 2:
Practice Address - City:WEST PLAINS
Practice Address - State:MO
Practice Address - Zip Code:65775-7665
Practice Address - Country:US
Practice Address - Phone:417-255-8302
Practice Address - Fax:417-255-8389
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-30
Last Update Date:2010-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2002001055111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO755808706Medicaid
MO755808706Medicaid
MOU88180Medicare UPIN