MEDICARE: J&L PAINSTOP OF ARNOLD 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	:	1518478361
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	J&L PAINSTOP OF ARNOLD LLC

Provider Business Mailing Address
First Line	:	4434 S LINDBERGH BLVD
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63127-1647
Country	:	US
Telephone Number	:	314-230-9044
Fax Number	:	636-287-3440

Provider Business Practice Location Address
First Line	:	4434 S LINDBERGH BLVD
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63127-1647
Country	:	US
Telephone Number	:	314-230-9044
Fax Number	:	636-287-3440

Authorized Official
Title or Position	:	OWNER
Name	:	MR. JUSTIN HILL
Credential	:	DC
Telephone Number	:	314-230-9044

Provider Enumeration Date	:	10/19/2017
Last Update Date	:	12/05/2018

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