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General NPI Number Information
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NPI Number | 1750245080
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Entity Type | Organization
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Legal Business Name | RAPHA CHIROPRACTIC
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Dates
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Enumeration Date | 12/11/2025
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Last Update Date | 12/11/2025
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Provider Practice Location Address
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Address Line | 12636 LAMPLIGHTER SQUARE SHPG CTR
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City | SAINT LOUIS
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State | MO
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Zip | 63128-2746
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Country | US
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Telephone | 856-430-4531
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Fax |
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Provider Business Mailing Address
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Address Line | 12906 AUTUMN VIEW DR
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City | SAINT LOUIS
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State | MO
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Zip | 63146-4331
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JENNIFER LEARY
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Credential | DC
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Telephone | 856-430-4531
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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 |
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License Number State |
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