MEDICARE: DR. AMANDA DRUM DC

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	2021001553	MO

General Provider Information

NPI Number	:	1376133413
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AMANDA DRUM DC

Provider Business Mailing Address
First Line	:	281 VIVARON AVE
Second Line	:
City	:	SAINT CHARLES
State	:	MO
Zip	:	63303-4217
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1755 STUMP RD
Second Line	:
City	:	DARDENNE PRAIRIE
State	:	MO
Zip	:	63368-6716
Country	:	US
Telephone Number	:	636-922-0777
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/22/2021
Last Update Date	:	01/22/2021

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