Healthcare Provider Details

I. General information

NPI: 1740009919
Provider Name (Legal Business Name): ALIANNA WARICH DC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/07/2024
Last Update Date: 10/07/2024
Certification Date: 10/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2050 WOODSON RD
OVERLAND MO
63114-5644
US

IV. Provider business mailing address

2528 TEXAS AVE APT 212
SAINT LOUIS MO
63104-2319
US

V. Phone/Fax

Practice location:
  • Phone: 314-447-0725
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2024016408
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: