Healthcare Provider Details

I. General information

NPI: 1033432646
Provider Name (Legal Business Name): BEUTEL CHIROPRACTIC & WELLNESS CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/10/2010
Last Update Date: 03/10/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6060 TELEGRAPH RD STE A
SAINT LOUIS MO
63129-4762
US

IV. Provider business mailing address

6060 TELEGRAPH RD STE A
SAINT LOUIS MO
63129-4762
US

V. Phone/Fax

Practice location:
  • Phone: 314-846-8800
  • Fax: 314-846-8840
Mailing address:
  • Phone: 314-846-8800
  • Fax: 314-846-8840

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2010000897
License Number StateMO

VIII. Authorized Official

Name: DR. EMBER BEUTEL
Title or Position: CHIROPRACTOR
Credential: D.C.
Phone: 314-846-8800