MEDICARE: NEARY CHIROPRACTIC CENTER 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
1	111N00000X	Chiropractor

General Provider Information

NPI Number	:	1053118810
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEARY CHIROPRACTIC CENTER LLC

Provider Business Mailing Address
First Line	:	1030 OLD DES PERES RD
Second Line	:
City	:	DES PERES
State	:	MO
Zip	:	63131-1865
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1030 OLD DES PERES RD
Second Line	:
City	:	DES PERES
State	:	MO
Zip	:	63131-1865
Country	:	US
Telephone Number	:	314-966-8989
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	SEAN NEARY
Credential	:
Telephone Number	:	314-966-8989

Provider Enumeration Date	:	02/28/2025
Last Update Date	:	12/02/2025

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