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General NPI Number Information
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NPI Number | 1306028774
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Entity Type | Organization
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Legal Business Name | MIDWEST CONSULTING AND IME
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Dates
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Enumeration Date | 11/28/2007
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Last Update Date | 04/03/2009
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Provider Practice Location Address
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Address Line | 763 S NEW BALLAS RD SUITE 230
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City | CREVE COEUR
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State | MO
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Zip | 63141-8704
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Country | US
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Telephone | 314-681-2800
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Fax | 314-432-5088
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Provider Business Mailing Address
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Address Line | 16412 GREEN PINES DR
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City | WILDWOOD
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State | MO
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Zip | 63011-1850
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Country | US
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Telephone | 314-378-6071
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | DR. SCOTT F HAINZ
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Credential | DC
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Telephone | 314-378-6071
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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 | CEO5286
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License Number State | MO
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