Healthcare Provider Details

I. General information

NPI: 1912246950
Provider Name (Legal Business Name): GERALD B. VANDEN HOEK D/B/A MEDICAL ALTERNATIVES OF MISSOURI
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/12/2013
Last Update Date: 02/22/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2249 S BRENTWOOD BLVD
SAINT LOUIS MO
63144-1834
US

IV. Provider business mailing address

2249 SOUTH BRENTWOOD BLVD.
ST. LOUIS MO
63144
US

V. Phone/Fax

Practice location:
  • Phone: 314-299-1524
  • Fax:
Mailing address:
  • Phone: 314-299-1524
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111NN0400X
TaxonomyNeurology Chiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code111NX0800X
TaxonomyOrthopedic Chiropractor
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. GERALD B VANDEN HOEK
Title or Position: OWNER
Credential: D.C.
Phone: 314-299-1524