Healthcare Provider Details

I. General information

NPI: 1114831633
Provider Name (Legal Business Name): ENDWELL CHIROPRACTIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/01/2026
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 W LOCKWOOD AVE STE 108
SAINT LOUIS MO
63119-2353
US

IV. Provider business mailing address

220 W LOCKWOOD AVE STE 108
SAINT LOUIS MO
63119-2353
US

V. Phone/Fax

Practice location:
  • Phone: 636-795-6049
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. AMANDA ALCAMO
Title or Position: OWNER
Credential: DC
Phone: 636-795-6049