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General NPI Number Information
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NPI Number | 1790732642
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Entity Type | Organization
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Legal Business Name | HENDRICKS CHIROPRACTIC
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Dates
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Enumeration Date | 05/27/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2901 UNION ROAD 2ND FLOOR
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City | ST LOUIS
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State | MO
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Zip | 63125
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Country | US
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Telephone | 314-892-2598
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Fax | 314-894-0157
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Provider Business Mailing Address
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Address Line | 2901 UNION ROAD 2ND FLOOR
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City | ST LOUIS
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State | MO
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Zip | 63125
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Country | US
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Telephone | 314-892-2598
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Fax | 314-894-0157
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Authorized Official
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Title or Position | DR ASSISTANT
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Name | MISS DIANE MARIE BOYER
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Credential |
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Telephone | 314-892-2598
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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 | 003657
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License Number State | MO
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