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General NPI Number Information
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NPI Number | 1871801142
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Entity Type | Organization
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Legal Business Name | PERRETTA HOLISITE SERVICES INC.
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Dates
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Enumeration Date | 09/20/2010
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Last Update Date | 09/26/2010
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Provider Practice Location Address
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Address Line | 10000 WATSON RD STE 2L-12
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City | SAINT LOUIS
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State | MO
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Zip | 63126-1854
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Country | US
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Telephone | 314-821-9776
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Fax |
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Provider Business Mailing Address
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Address Line | 10000 WATSON RD STE 2L-12
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City | SAINT LOUIS
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State | MO
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Zip | 63126-1854
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Country | US
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Telephone | 314-821-9776
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. LOUIS A PERRETTA
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Credential | DC
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Telephone | 314-821-9776
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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 | 2001003451
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License Number State | MO
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