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General NPI Number Information
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NPI Number | 1023788577
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Entity Type | Organization
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Legal Business Name | PREMIER CHIROPRACTIC
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Dates
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Enumeration Date | 09/16/2021
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Last Update Date | 10/14/2021
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Provider Practice Location Address
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Address Line | 1120 WOLFRUM RD STE 101
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City | WELDON SPRING
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State | MO
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Zip | 63304-7958
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Country | US
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Telephone | 412-596-1774
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Fax |
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Provider Business Mailing Address
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Address Line | 1120 WOLFRUM RD STE 101
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City | WELDON SPRING
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State | MO
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Zip | 63304-7958
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LAURA STEPHENSON
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Credential | DC
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Telephone | 636-244-1748
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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