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General NPI Number Information
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NPI Number | 1720122401
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Entity Type | Organization
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Legal Business Name | DEVEREUX CHIROPRACTIC & ACUPUNCTURE LLC
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Dates
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Enumeration Date | 02/16/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4500 TELEGRAPH SUITE 104
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City | ST LOUIS
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State | MO
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Zip | 63129
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Country | US
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Telephone | 314-894-1842
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Fax |
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Provider Business Mailing Address
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Address Line | 4500 TELEGRAPH RD SUITE 104
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City | ST LOUIS
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State | MO
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Zip | 63129
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Country | US
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Telephone | 314-894-1842
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Fax |
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Authorized Official
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Title or Position | DOCTOR OWNER
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Name | DR. SCOTT LOUIS DEVEREUX
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Credential | DC
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Telephone | 314-894-1842
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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 | 006736
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License Number State | MO
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