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General NPI Number Information
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NPI Number | 1386763696
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Entity Type | Organization
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Legal Business Name | COMMITTED TO HEALTH CHIROPRACTIC CENTER, LLC
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Dates
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Enumeration Date | 03/28/2007
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Last Update Date | 07/02/2008
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Provider Practice Location Address
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Address Line | 13035 OLIVE BLVD SUITE 216
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City | CREVE COEUR
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State | MO
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Zip | 63141-6173
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Country | US
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Telephone | 314-542-2003
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Fax | 314-542-2007
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Provider Business Mailing Address
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Address Line | 13035 OLIVE BLVD SUITE 216
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City | CREVE COEUR
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State | MO
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Zip | 63141-6173
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Country | US
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Telephone | 314-542-2003
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Fax | 314-542-2007
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. PAUL B HYLAND
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Credential | D. C.
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Telephone | 314-542-2003
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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 | 2005013007
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License Number State | MO
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