=====================================================
General NPI Number Information
=====================================================
NPI Number | 1902289945
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | A BETTER YOU CHIROPRACTIC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/08/2015
-----------------------------------------------------
Last Update Date | 07/08/2015
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 22 WILD DEER LN
-----------------------------------------------------
City | SAINT PETERS
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 63376-4231
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 314-489-8084
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4122 KEATON CROSSING BLVD SUITE 105
-----------------------------------------------------
City | O FALLON
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 63368-8218
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 314-489-8084
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CHIROPRACTOR
-----------------------------------------------------
Name | DR. SHERI RENEE WILLIAMS
-----------------------------------------------------
Credential | DC
-----------------------------------------------------
Telephone | 314-489-8084
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | 2015020480
-----------------------------------------------------
License Number State | MO
-----------------------------------------------------