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NPI Code Detail

MEDICARE: BUCK CHIROPRACTIC, LLC

MEDICARE: BUCK CHIROPRACTIC, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111N00000XChiropractor2007000246MO

General Provider Information

NPI Number : 1003003476
Entity Type Code : Organization
Provider Name (Legal Business Name) : BUCK CHIROPRACTIC, LLC
Provider Business Mailing Address
First Line : 8641 WATSON RD
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63119-5109
Country : US
Telephone Number : 314-374-2503
Fax Number :
Provider Business Practice Location Address
First Line : 8641 WATSON RD
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63119-5109
Country : US
Telephone Number : 314-374-2503
Fax Number :
Authorized Official
Title or Position : OWNER
Name : DR. MATTHEW J BUCK
Credential : D.C.
Telephone Number : 314-962-3130
Provider Enumeration Date : 10/01/2007
Last Update Date : 07/22/2014

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Directions to “BUCK CHIROPRACTIC, LLC ” Practice Location

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