Healthcare Provider Details

I. General information

NPI: 1770081945
Provider Name (Legal Business Name): INTEGRATIVE CHIROPRACTIC, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2018
Last Update Date: 11/12/2024
Certification Date: 11/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7259 LANSDOWNE AVE # 400
SAINT LOUIS MO
63119-3402
US

IV. Provider business mailing address

8816 MANCHESTER RD # 202
SAINT LOUIS MO
63144-2602
US

V. Phone/Fax

Practice location:
  • Phone: 314-312-2686
  • Fax:
Mailing address:
  • Phone: 314-520-9442
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code111NP0017X
TaxonomyPediatric Chiropractor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. CHARLOTTE MEIER
Title or Position: OWNER
Credential: DC
Phone: 314-312-2686