MEDICARE: DR. GREGORY WADE EDSTROM D.C.

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	111N00000X	Chiropractor	03699	MO

General Provider Information

NPI Number	:	1447389119
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GREGORY WADE EDSTROM D.C.

Provider Business Mailing Address
First Line	:	5714 S LINDBERGH BLVD
Second Line	:	#7
City	:	AFFTON
State	:	MO
Zip	:	63123-6955
Country	:	US
Telephone Number	:	314-842-4929
Fax Number	:	314-842-1829

Provider Business Practice Location Address
First Line	:	5714 S LINDBERGH BLVD
Second Line	:	#7
City	:	AFFTON
State	:	MO
Zip	:	63123-6955
Country	:	US
Telephone Number	:	314-842-4929
Fax Number	:	314-842-1829

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/05/2007
Last Update Date	:	07/08/2007

Similar Medicare Providers

1235110792 — AFFTON FIRE PROTECTION DISTRICT
Practice Location Address:

9282 GRAVOIS RD
AFFTON, MO
63123-4526

Practice Phone: 314-631-1803
Practice Fax: 314-353-7679

1821181355 — TOMLYN, INC
Practice Location Address:

7922 MACKENZIE RD
AFFTON, MO
63123-2721

Practice Phone: 314-638-3535
Practice Fax: 314-638-0351

1619053907 — DR. DUY DUC NGUYEN D.C.
Practice Location Address:

4348 SCHMITTWOODS CT
AFFTON, MO
63123-6731

Practice Phone: 314-853-5455
Practice Fax:

1235264193 — MS. JANAN E HARTFORD MSW, LCSW
Practice Location Address:

6417 HURSTGREEN LN
AFFTON, MO
63123-1504

Practice Phone: 314-963-4605
Practice Fax:

1770613481 — DR. ALMA R. FULTON DMD
Practice Location Address:

4211 BAYLESS AVE STE B
AFFTON, MO
63123-7513

Practice Phone: 314-544-3434
Practice Fax: 314-544-3336

1295869352 — CHRISTINE VOGT PTA
Practice Location Address:

9541 HYDE PARK DR
AFFTON, MO
63123-7341

Practice Phone: 314-638-2009
Practice Fax:

Directions to “ DR. GREGORY WADE EDSTROM D.C.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.