Provider Demographics
NPI:1780321711
Name:SUMMIT HEALTH AND WELLNESS, LLC
Entity type:Organization
Organization Name:SUMMIT HEALTH AND WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:E
Authorized Official - Last Name:CHITWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:573-896-8008
Mailing Address - Street 1:75 S LARAND DR
Mailing Address - Street 2:
Mailing Address - City:HOLTS SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:65043-1132
Mailing Address - Country:US
Mailing Address - Phone:157-329-8190
Mailing Address - Fax:
Practice Address - Street 1:10423 OLD HWY 54
Practice Address - Street 2:SUITE B
Practice Address - City:NEW BLOOMFIELD
Practice Address - State:MO
Practice Address - Zip Code:65063-6506
Practice Address - Country:US
Practice Address - Phone:573-896-8008
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-20
Last Update Date:2022-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center