Healthcare Provider Details

I. General information

NPI: 1699289694
Provider Name (Legal Business Name): PRIMARY HEALTH CARE ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/29/2017
Last Update Date: 08/03/2021
Certification Date: 08/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5960 HOWDERSHELL RD STE 204
HAZELWOOD MO
63042-4103
US

IV. Provider business mailing address

5960 HOWDERSHELL RD STE 204
HAZELWOOD MO
63042-4103
US

V. Phone/Fax

Practice location:
  • Phone: 314-895-1136
  • Fax: 314-895-5040
Mailing address:
  • Phone: 314-895-1136
  • Fax: 314-895-5040

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DR. CHRISTINA MARIE LYNCH
Title or Position: OWNER
Credential: DC
Phone: 314-895-1136