Provider Demographics
NPI:1780260950
Name:BIO-KINETIC CLINICAL APPLICATIONS, LLC
Entity type:Organization
Organization Name:BIO-KINETIC CLINICAL APPLICATIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF COMPLIANCE
Authorized Official - Prefix:
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:
Authorized Official - Last Name:BUCKTHORPE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:417-893-6118
Mailing Address - Street 1:1820 W MOUNT VERNON ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65802-4842
Mailing Address - Country:US
Mailing Address - Phone:417-831-2048
Mailing Address - Fax:417-831-0715
Practice Address - Street 1:1820 W MOUNT VERNON ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65802-4842
Practice Address - Country:US
Practice Address - Phone:417-831-2048
Practice Address - Fax:417-831-0715
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-19
Last Update Date:2021-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health