Healthcare Provider Details

I. General information

NPI: 1730002338
Provider Name (Legal Business Name): MAKAYLA THOMAS DC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2026
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5811 CHIPPEWA ST
SAINT LOUIS MO
63109-1404
US

IV. Provider business mailing address

4626 HANNOVER AVE
SAINT LOUIS MO
63123-5819
US

V. Phone/Fax

Practice location:
  • Phone: 314-742-7536
  • Fax:
Mailing address:
  • Phone: 314-960-5979
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number038.014361
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2025037105
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: