Healthcare Provider Details

I. General information

NPI: 1104875111
Provider Name (Legal Business Name): MARY CAROL UNGER-BOYD D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2006
Last Update Date: 01/10/2026
Certification Date: 01/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8151 STATE ROAD B
CEDAR HILL MO
63016-3936
US

IV. Provider business mailing address

8151 STATE ROAD B
CEDAR HILL MO
63016-3936
US

V. Phone/Fax

Practice location:
  • Phone: 314-496-7371
  • Fax:
Mailing address:
  • Phone: 636-274-5437
  • Fax: 636-274-5439

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCEO 006549
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: