Healthcare Provider Details

I. General information

NPI: 1164624268
Provider Name (Legal Business Name): NORTH COUNTY CHIROPRACTIC CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2359 CHAMBERS RD
SAINT LOUIS MO
63136-5548
US

IV. Provider business mailing address

2359 CHAMBERS RD
SAINT LOUIS MO
63136-5548
US

V. Phone/Fax

Practice location:
  • Phone: 314-868-2220
  • Fax: 314-868-2640
Mailing address:
  • Phone: 314-868-2220
  • Fax: 314-868-2640

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number
License Number StateMO

VIII. Authorized Official

Name: DR. ROBERT E RIMMER
Title or Position: PRESIDENT
Credential: D.C.
Phone: 314-868-2220