NPI | 1306203096 |
---|---|
Other Name | IMAC REGENERATION CENTER OF ST. LOUIS |
Entity Type | Organization |
Authorized Contact | THERESA LUECKE Human Resources 270-554-5114 |
Organization Subpart ? | No |
Primary Taxonomy | 207QS0010X Family Medicine Sports Medicine |
Additional Taxonomies | 111N00000X Chiropractor |
111NX0800X Chiropractor Orthopedic | |
207L00000X Anesthesiology | |
207XX0005X Orthopaedic Surgery Sports Medicine | |
208100000X Physical Medicine & Rehabilitation | |
208VP0000X Pain Medicine Pain Medicine | |
225100000X Physical Therapist | |
225700000X Massage Therapist | |
225X00000X Occupational Therapist | |
227800000X Respiratory Therapist, Certified | |
363AM0700X Physician Assistant Medical | |
363LP2300X Nurse Practitioner Primary Care | |
363LX0106X Nurse Practitioner Occupational Health | |
Enumeration Date | 2016-01-26 |
Last Update Date | 2020-08-19 |