Healthcare Provider Details

I. General information

NPI: 1538295290
Provider Name (Legal Business Name): CAROLINE ANNE SEYMOUR D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/26/2007
Last Update Date: 11/19/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4187 CRESCENT DR SUITE A
SAINT LOUIS MO
63129-1098
US

IV. Provider business mailing address

4187 CRESCENT DR SUITE A
SAINT LOUIS MO
63129-1098
US

V. Phone/Fax

Practice location:
  • Phone: 314-892-4101
  • Fax: 314-892-4120
Mailing address:
  • Phone: 314-892-4101
  • Fax: 314-892-4120

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NN0400X
TaxonomyNeurology Chiropractor
License Number2001020199
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License Number2001020199
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: