Healthcare Provider Details

I. General information

NPI: 1255113403
Provider Name (Legal Business Name): COURY SPINE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/20/2023
Last Update Date: 10/30/2023
Certification Date: 10/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

226 S WOODS MILL RD STE 35W
CHESTERFIELD MO
63017-3442
US

IV. Provider business mailing address

226 S WOODS MILL RD STE 35W
CHESTERFIELD MO
63017-3442
US

V. Phone/Fax

Practice location:
  • Phone: 314-548-6860
  • Fax: 314-548-6866
Mailing address:
  • Phone: 314-548-6860
  • Fax: 314-548-6866

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JOHN COURY
Title or Position: OWNER
Credential: DO
Phone: 314-548-6860