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General NPI Number Information
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NPI Number | 1720278559
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Entity Type | Organization
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Legal Business Name | LITTLETON CHIROPRACTIC CLINIC LLC
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Dates
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Enumeration Date | 07/27/2007
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Last Update Date | 06/21/2018
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Provider Practice Location Address
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Address Line | 8420 DELMAR BLVD SUITE 305
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City | SAINT LOUIS
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State | MO
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Zip | 63124-2170
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Country | US
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Telephone | 314-997-4460
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Fax | 314-997-2306
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Provider Business Mailing Address
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Address Line | 8420 DELMAR BLVD SUITE 305
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City | SAINT LOUIS
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State | MO
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Zip | 63124-2170
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Country | US
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Telephone | 314-997-4460
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Fax | 314-997-2306
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Authorized Official
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Title or Position | CHIROPRACTOR/OWNER
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Name | DR. MELANEY YAJUAN LITTLETON
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Credential | D.C.
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Telephone | 314-997-4460
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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 | 2004021551
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License Number State | MO
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