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General NPI Number Information
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NPI Number | 1609395300
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Entity Type | Organization
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Legal Business Name | MEAGAN HINZMAN CHIROPRACTIC AND WELLNESS, L.L.C.
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Dates
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Enumeration Date | 09/13/2017
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Last Update Date | 11/06/2017
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Provider Practice Location Address
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Address Line | 173 LONG RD STE 100
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City | CHESTERFIELD
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State | MO
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Zip | 63005-1255
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Country | US
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Telephone | 314-960-9886
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Fax |
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Provider Business Mailing Address
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Address Line | 224 HUNTERS POINTE DR
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City | SAINT CHARLES
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State | MO
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Zip | 63304-7134
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Country | US
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Telephone | 636-875-2397
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MEAGAN HINZMAN
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Credential | DC
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Telephone | 636-875-2397
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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 | 2017031984
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License Number State | MO
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