MEDICARE: TIPLER CHIROPRACTIC & REHABILITATION 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	111NR0400X	Rehabilitation Chiropractor	2006030819	MO

General Provider Information

NPI Number	:	1164643680
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TIPLER CHIROPRACTIC & REHABILITATION LLC

Provider Business Mailing Address
First Line	:	2050 WOODSON RD STE 101
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63114-5644
Country	:	US
Telephone Number	:	314-447-0725
Fax Number	:	314-447-0726

Provider Business Practice Location Address
First Line	:	2050 WOODSON RD STE 101
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63114-5644
Country	:	US
Telephone Number	:	314-447-0725
Fax Number	:	314-447-0726

Authorized Official
Title or Position	:	DOCTOR OF CHIROPRACTIC
Name	:	DR. XAIVIER T TIPLER SR.
Credential	:	D.C.
Telephone Number	:	314-447-0725

Provider Enumeration Date	:	05/01/2007
Last Update Date	:	06/07/2010

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