Healthcare Provider Details

I. General information

NPI: 1346431277
Provider Name (Legal Business Name): NADIM TOUFIC NASRALLAH M.S., D.C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

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

III. Provider practice location address

11500 OLIVE BLVD SUITE 112
CREVE COEUR MO
63141-7143
US

IV. Provider business mailing address

11500 OLIVE BLVD SUITE 112
CREVE COEUR MO
63141-7143
US

V. Phone/Fax

Practice location:
  • Phone: 314-997-7770
  • Fax:
Mailing address:
  • Phone: 314-997-7770
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NI0013X
TaxonomyIndependent Medical Examiner Chiropractor
License Number3538
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: