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General NPI Number Information
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NPI Number | 1033586847
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Entity Type | Organization
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Legal Business Name | ARBAVADA CHIROPRACTIC AND WELLNESS CENTER LLC
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Dates
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Enumeration Date | 08/27/2015
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Last Update Date | 09/21/2015
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Provider Practice Location Address
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Address Line | 1552 NATCHEZ DR
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City | FESTUS
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State | MO
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Zip | 63028-2353
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Country | US
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Telephone | 636-937-7771
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Fax | 636-937-7775
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Provider Business Mailing Address
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Address Line | 1552 NATCHEZ DR
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City | FESTUS
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State | MO
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Zip | 63028-2353
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Country | US
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Telephone | 636-937-7771
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Fax | 636-937-7775
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Authorized Official
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Title or Position | OWNER/OPERATOR
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Name | DR. PATRICK W SMITH
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Credential | DC
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Telephone | 314-603-7301
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 2014010611
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License Number State | MO
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