Healthcare Provider Details

I. General information

NPI: 1528262474
Provider Name (Legal Business Name): ACCESS HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3430 MCKELVEY RD SUITE H
BRIDGETON MO
63044-2556
US

IV. Provider business mailing address

630 BROADMOOR DR SUITE A
CHESTERFIELD MO
63017-3124
US

V. Phone/Fax

Practice location:
  • Phone: 314-291-1516
  • Fax:
Mailing address:
  • Phone: 314-374-9399
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code305S00000X
TaxonomyPoint of Service
License Number2007007207
License Number StateMO

VIII. Authorized Official

Name: MS. STEPHANIE MARIE HICKS
Title or Position: OWNER
Credential: DC
Phone: 314-374-9399