MEDICARE: NATURAL RESTORATION AND WOMEN'S HEALTH CENTER

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
1	111N00000X	Chiropractor	3372	SC
2	225100000X	Physical Therapist	2004032527	MO
3	225100000X	Physical Therapist	5740	SC
4	111N00000X	Chiropractor	2007029215	MO

General Provider Information

NPI Number	:	1023345311
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NATURAL RESTORATION AND WOMEN'S HEALTH CENTER

Provider Business Mailing Address
First Line	:	2303 MCKELVEY RD
Second Line	:
City	:	MARYLAND HEIGHTS
State	:	MO
Zip	:	63043-1531
Country	:	US
Telephone Number	:	314-878-9355
Fax Number	:

Provider Business Practice Location Address
First Line	:	2303 MCKELVEY RD
Second Line	:
City	:	MARYLAND HEIGHTS
State	:	MO
Zip	:	63043-1531
Country	:	US
Telephone Number	:	314-878-9355
Fax Number	:

Authorized Official
Title or Position	:	OWNER/PROVIDER
Name	:	MARY G HARPELL
Credential	:	DC., PT.
Telephone Number	:	314-856-2565

Provider Enumeration Date	:	11/09/2009
Last Update Date	:	11/09/2009

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