MEDICARE: WALTON CS-IX INC

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	:	1801981725
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WALTON CS-IX INC

Provider Business Mailing 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	:	636-922-0833

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	:	636-922-0833

Authorized Official
Title or Position	:	OWNER
Name	:	DR. JOSHUA MICHAEL FINK
Credential	:	DC
Telephone Number	:	636-922-0777

Provider Enumeration Date	:	10/04/2006
Last Update Date	:	05/20/2021

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