Healthcare Provider Details

I. General information

NPI: 1932182235
Provider Name (Legal Business Name): STEVEN JEROME MEACHAM DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/22/2005
Last Update Date: 08/28/2023
Certification Date: 08/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1023 MAIN PLAZA DR
WENTZVILLE MO
63385-1170
US

IV. Provider business mailing address

1023 MAIN PLAZA DR
WENTZVILLE MO
63385-1170
US

V. Phone/Fax

Practice location:
  • Phone: 636-327-3333
  • Fax: 636-639-8922
Mailing address:
  • Phone: 636-327-3333
  • Fax: 636-639-8922

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number004730
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: