Healthcare Provider Details

I. General information

NPI: 1437648623
Provider Name (Legal Business Name): DEVON LOWELL ACKROYD DC, MS, DACBSP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/03/2018
Last Update Date: 10/05/2022
Certification Date: 10/05/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10279 CLAYTON RD
SAINT LOUIS MO
63124-1115
US

IV. Provider business mailing address

10279 CLAYTON RD
SAINT LOUIS MO
63124-1115
US

V. Phone/Fax

Practice location:
  • Phone: 314-390-9915
  • Fax:
Mailing address:
  • Phone: 314-550-6220
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2018001705
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number2018001705
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: