NPI UPIN EIN DBA_BUSINESS_NAME BUSINESS_NAME FORMER_BUSINESS_NAME SPECIALTY ENUM_DATE DEACT_DATE REACT_DATE AUTH_OFFICIAL_TITLE AUTH_OFFICIAL_FIRST AUTH_OFFICIAL_MIDDLE AUTH_OFFICIAL_LAST AUTH_OFFICIAL_TEL MAILINGADDR_LN1 MAILINGADDR_LN2 MAILINGADDR_CITY MAILINGADDR_ST MAILINGADDR_POSTCODE MAILINGADDR_COUNTRY MAILINGADDR_TEL MAILINGADDR_FAX PRACADDR_LN1 PRACADDR_LN2 PRACADDR_CITY PRACADDR_ST PRACADDR_POSTCODE PRACADDR_COUNTRY PRACADDR_TEL PRACADDR_FAX 1003000563 E33595 Richard B. D. Chun, M.D. a Professional Corporation Gastroenterology 08-28-2007 President Richard B. Chun 916-783-7118 729 Sunrise Ave Ste 619 Roseville CA 95661-4565 US 916-783-7118 729 Sunrise Ave Ste 619 Roseville CA 95661-4565 US 916-783-7118 1003000571 House Of Care Center Psychiatric Residential Treatment Facility 08-28-2007 Administrator Philomina Nonyerem Ikpe 816-921-6852 3744 Benton Blvd Kansas City MO 64128-2515 US 816-921-6852 3744 Benton Blvd Kansas City MO 64128-2515 US 816-921-6852 1003000613 U64605 Whole Health Chiropractic, PA Chiropractor 08-28-2007 Owner Erika Lynn Putnam 208-442-1123 430 W. Iowa Ave. Suite A Nampa ID 83686-2856 US 208-442-1123 208-442-1127 430 W. Iowa Ave. Suite A Nampa ID 83686-2856 US 208-442-1123 208-442-1127 1003000670 Dr. Jeff Snyder, LLC Chiropractor 08-28-2007 Owner Jeffrey Scott Snyder 610-329-2273 PO Box 761 Oaks PA 19456-0761 US 610-329-2273 1003A Egypt Road Oaks PA 19456 US 610-329-2273 1003000688 U12082 Husske Chiropractic Clinic Chiropractor 08-28-2007 Provider/Owner Brian A Husske 307-674-7433 1265 Coffeen Ave Sheridan WY 82801-5325 US 307-674-7433 307-674-6808 1265 Coffeen Ave Sheridan WY 82801-5325 US 307-674-7433 307-674-6808 1003000696 Almond Bancroft School District Local Education Agency (LEA) 08-28-2007 District Administrator Dan Boxx 715-366-2941 1336 Elm St Almond WI 54909-9785 US 1336 Elm St Almond WI 54909-9785 US 715-366-2941 715-366-2940 1003006008 Holy Family Maternity Support Services Providence Health Care General Acute Care Hospital 07-26-2007 Director Of Finance Debbie L Wicklund 509-232-1177 910 N Washington St Suite 209 Spokane WA 99201-2202 US 509-232-1173 509-232-1165 5633 N Lidgerwood St Spokane WA 99208-1224 US 509-482-0111 509-482-2456 1003006032 Lane M. Cook, M.D. Psychiatry 07-26-2007 Sole proprietor Lane Marshall Cook 865-588-6425 PO Box 10187 Knoxville TN 37939-0187 US 865-588-6425 865-584-8066 4428 Sutherland Ave Knoxville TN 37919-5008 US 865-588-6425 865-584-8066 1003006040 New Mexico Surgical Assoc Specialist 07-26-2007 President Robert Lowe 505-843-7901 711 Encino Pl Ne Albuquerque NM 87102 US 505-843-7901 505-843-6384 711 Encino Pl NE Albuquerque NM 87102-2619 US 505-843-7901 505-843-6384 1003006057 Eye and Vision Management Optometrist 07-26-2007 Partner Agustin L Gonzalez 972-423-3937 3417 Spectrum Blvd Suite 100 Richardson TX 75082-9705 US 972-423-3937 3417 Spectrum Blvd Suite 100 Richardson TX 75082-9705 US 972-423-3937 1003006065 John Francis Nielsen fFamily Medicine PA Family Medicine 07-26-2007 President John Francis Nielsen 903-694-4991 702 Davis St Ste 4 Carthage TX 75633-1461 US 702 Davis St Ste 4 Carthage TX 75633-1461 US 903-694-4991 1003006081 On Wheels Transport N-MET, Inc Non-emergency Medical Transport (VAN) 07-26-2007 President James B. Keith 561-542-8800 3700 Georgia Ave #9 West Palm Beach FL 33405-2176 US 561-542-8800 561-586-8644 3700 Georgia Ave #9 West Palm Beach FL 33405-2176 US 561-542-8800 561-586-8644 1003006123 U46999 InVision Eyecare Inc Optometrist 07-25-2007 President Douglas Ronald Tupps 727-734-8843 2161 Main St Dunedin FL 34698-5606 US 727-734-8843 727-733-4313 2161 Main St Dunedin FL 34698-5606 US 727-734-8843 727-733-4313 1003006156 Laborde Dermatology, PA Specialist 07-25-2007 Physician Stephen Van Laborde 713-960-0700 1333 West Loop S Ste 1425 Houston TX 77027-9121 US 713-960-0700 713-960-0761 1333 West Loop S Ste 1425 Houston TX 77027-9121 US 713-960-0700 713-960-0761 1003006180 MedicWest Ambulance, Inc Ambulance 07-26-2007 Presicent and COO Don S Harvey 303-495-1229 PO Box 98595 Las Vegas NV 89193-8595 US 9 W Delhi Ave North Las Vegas NV 89032-7836 US 702-224-5056 1003006222 America's Best Contacts and Eyeglasses Optician 07-25-2007 Manager Provider Relations Anna Purcell 770-822-4245 296 Grayson Hwy Lawrenceville GA 30045-5737 US 770-822-3600 800 N Kedzie Ave Suite 223 Chicago IL 60651-4100 US 773-733-0326 1003006255 Manual Therapy Associates Physical Therapist 07-25-2007 Owner Katherine A Behrens 317-817-9930 13431 Old Meridian St Suite 100 Carmel IN 46032-7101 US 317-817-9930 317-375-7908 13431 Old Meridian St Suite 100 Carmel IN 46032-7101 US 317-817-9930 317-375-7908 1003006263 Thomas Business Enterprises, Inc Home Health Agency 07-25-2007 Director Marsha Victoria Thomas-Roberts 314-382-9700 23 N Oaks Plz Suite 250 Saint Louis MO 63121-2917 US 314-382-9700 314-385-2500 23 N Oaks Plz Suite 250 Saint Louis MO 63121-2917 US 314-382-9700 314-385-2500 1003006289 Waddell Center Family Practice Family Medicine 07-25-2007 Compliance James Randy Comer 256-233-9172 PO Box 999 Athens AL 35612-0999 US 256-216-9777 902 W Washington St Athens AL 35611-2438 US 256-216-9777 1003006313 Utah Valley Pain Management Exclusive Provider Organization 08-01-2007 C.O.O. Leon James Jensen 801-225-6246 283 E 930 S Orem UT 84058-5001 US 801-225-6246 801-225-1525 412 W. 800 N. Orem UT 84057 US 801-802-9729