Healthcare Provider Details

I. General information

NPI: 1083577407
Provider Name (Legal Business Name): BACK SPECIALIST CHIROPRACTIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/03/2025
Last Update Date: 12/03/2025
Certification Date: 12/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10807 BIG BEND RD
KIRKWOOD MO
63122-6070
US

IV. Provider business mailing address

345 JEFFERSON CIRCLE DR
FENTON MO
63026-3985
US

V. Phone/Fax

Practice location:
  • Phone: 314-600-7651
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. JOSEPH WILLIAM KAUFMANN
Title or Position: OWNER
Credential: D.C.
Phone: 314-740-3115