| |
2918 Sutton Boulevard, Maplewood, MO 63143-3012 | |
(314) 781-0063 | |
(314) 499-9044 |
Full Name | |
---|---|
Type | Facility |
Speciality | Clinic/center |
Location | 2918 Sutton Boulevard, Maplewood, Missouri |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1821313297 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111N00000X | Chiropractor | (* (Not Available)) | Secondary |
261Q00000X | Clinic/center | 2003017485 (Missouri) | Primary |
Mailing Address | Practice Location Address |
---|---|
2918 Sutton Boulevard, Maplewood, MO 63143-3012 Ph: (314) 781-0063 | 2918 Sutton Boulevard, Maplewood, MO 63143-3012 Ph: (314) 781-0063 |