Healthcare Provider Details

I. General information

NPI: 1467593616
Provider Name (Legal Business Name): JENNIFER BLEI, D.C., LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/09/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1023 MAIN PLAZA DR
WENTZVILLE MO
63385-1170
US

IV. Provider business mailing address

3438 RIVERCHASE PKWY
SAINT CHARLES MO
63301-4112
US

V. Phone/Fax

Practice location:
  • Phone: 636-639-8944
  • Fax: 636-369-8922
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2006012185
License Number StateMO

VIII. Authorized Official

Name: DR. JENNIFER LINDSAY BLEI
Title or Position: CHIROPRACTOR
Credential: D.C.
Phone: 314-504-2620