Healthcare Provider Details

I. General information

NPI: 1578768602
Provider Name (Legal Business Name): WENDI LORRAINE JONES DC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/19/2007
Last Update Date: 03/03/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

918 HEMSATH ROAD SUITE 102B
ST CHARLES MO
63303
US

IV. Provider business mailing address

2007 LUNENBURG ROAD
ST PETERS MO
63376-8123
US

V. Phone/Fax

Practice location:
  • Phone: 636-949-2771
  • Fax: 636-949-2771
Mailing address:
  • Phone: 636-721-4872
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NI0013X
TaxonomyIndependent Medical Examiner Chiropractor
License NumberMO2003011569
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: