Healthcare Provider Details

I. General information

NPI: 1255411427
Provider Name (Legal Business Name): 370 CHIROPRACTIC AND REHABILITATION PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/16/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3737 ELM STREET
ST CHARLES MO
63301
US

IV. Provider business mailing address

3737 ELM STREET
ST CHARLES MO
63301
US

V. Phone/Fax

Practice location:
  • Phone: 636-925-3933
  • Fax: 636-925-8338
Mailing address:
  • Phone: 636-925-3933
  • Fax: 636-925-8338

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2000170042
License Number StateMO

VIII. Authorized Official

Name: DR. JEFFREY MYERS ERWIN
Title or Position: PRESIDENT
Credential: DC
Phone: 636-925-3933