Healthcare Provider Details

I. General information

NPI: 1033022751
Provider Name (Legal Business Name): SHAE DWYER DC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/24/2026
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

78 CLARKSON WILSON CTR STE 5
CHESTERFIELD MO
63017-7277
US

IV. Provider business mailing address

424 CAMBRIDGE PL
SAINT PETERS MO
63376-5404
US

V. Phone/Fax

Practice location:
  • Phone: 314-651-1808
  • Fax:
Mailing address:
  • Phone: 314-651-1808
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111NP0017X
TaxonomyPediatric Chiropractor
License Number2026046218
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2026046218
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: