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General NPI Number Information
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NPI Number | 1881843894
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Entity Type | Organization
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Legal Business Name | WALTON C.S. VIII, INC.
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Dates
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Enumeration Date | 09/15/2008
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Last Update Date | 11/05/2008
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Provider Practice Location Address
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Address Line | 1000 CORPORATE PKWY SUITE102
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City | WENTZVILLE
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State | MO
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Zip | 63385-4859
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Country | US
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Telephone | 636-327-4446
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Fax | 636-327-0446
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Provider Business Mailing Address
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Address Line | 1000 CORPORATE PKWY SUITE102
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City | WENTZVILLE
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State | MO
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Zip | 63385-4859
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Country | US
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Telephone | 636-327-4446
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Fax | 636-327-0446
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Authorized Official
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Title or Position | OWNER/DOCTOR
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Name | RJ R RUNGE
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Credential | D.C.
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Telephone | 636-327-4446
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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 | 2002025276
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License Number State | MO
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