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NPI Code Detail

MEDICARE: LAUREN ALISON MEDINA DC

MEDICARE:   LAUREN ALISON MEDINA  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
1111N00000XChiropractor2020000337MO

General Provider Information

NPI Number : 1699314880
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAUREN ALISON MEDINA DC
Provider Business Mailing Address
First Line : 1756 WILMES RD
Second Line :
City : WENTZVILLE
State : MO
Zip : 63385-3024
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 17197 NEW COLLEGE AVE
Second Line :
City : WILDWOOD
State : MO
Zip : 63040-1100
Country : US
Telephone Number : 636-273-4800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/05/2020
Last Update Date : 01/05/2020

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Directions to “ LAUREN ALISON MEDINA DC” Practice Location

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