MEDICARE: ST. LOUIS HEALTHCARE SOLUTIONS LLC

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	2004030634	MO

General Provider Information

NPI Number	:	1962919647
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ST. LOUIS HEALTHCARE SOLUTIONS LLC

Provider Business Mailing Address
First Line	:	706 WINDINGPATH LN
Second Line	:
City	:	MANCHESTER
State	:	MO
Zip	:	63021-6634
Country	:	US
Telephone Number	:	314-580-4336
Fax Number	:

Provider Business Practice Location Address
First Line	:	4704 SHREWSBURY AVE
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63119-3304
Country	:	US
Telephone Number	:	314-540-1318
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. MATTHEW FRENZEL
Credential	:	DC
Telephone Number	:	314-540-1318

Provider Enumeration Date	:	01/04/2018
Last Update Date	:	01/04/2018

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