MEDICARE: PROFICIENT CHIROPRACTIC WEST END

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM2500X	Medical Specialty Clinic/Center

General Provider Information

NPI Number	:	1093585226
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PROFICIENT CHIROPRACTIC WEST END

Provider Business Mailing Address
First Line	:	2050 WOODSON RD STE 101
Second Line	:
City	:	OVERLAND
State	:	MO
Zip	:	63114-5644
Country	:	US
Telephone Number	:	314-447-0725
Fax Number	:	314-447-0726

Provider Business Practice Location Address
First Line	:	305 UNION BLVD
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63108-1229
Country	:	US
Telephone Number	:	314-447-0725
Fax Number	:	314-447-0726

Authorized Official
Title or Position	:	MANAGER
Name	:	DR. XAIVIER TIPLER
Credential	:	DC
Telephone Number	:	314-447-0725

Provider Enumeration Date	:	01/08/2024
Last Update Date	:	01/06/2025

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