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NPI Code Detail

MEDICARE: WILKS CHIROPRACTIC

MEDICARE: WILKS CHIROPRACTIC
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
1261Q00000XClinic/Center2008028550MO

General Provider Information

NPI Number : 1346494226
Entity Type Code : Organization
Provider Name (Legal Business Name) : WILKS CHIROPRACTIC
Provider Business Mailing Address
First Line : 2241 BLUESTONE DR
Second Line :
City : SAINT CHARLES
State : MO
Zip : 63303-6705
Country : US
Telephone Number : 636-925-1918
Fax Number : 636-825-0128
Provider Business Practice Location Address
First Line : 2241 BLUESTONE DR
Second Line :
City : SAINT CHARLES
State : MO
Zip : 63303-6705
Country : US
Telephone Number : 636-925-1918
Fax Number : 636-825-0128
Authorized Official
Title or Position : OWNER
Name : DR. KRISTA ELIZABETH WILKS
Credential : D.C.
Telephone Number : 636-925-1918
Provider Enumeration Date : 11/05/2008
Last Update Date : 11/05/2008

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Directions to “WILKS CHIROPRACTIC ” Practice Location

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