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Organization
INTEGRATED MEDICINE AND CHIROPRACTIC REGENERATION CENTER O
Active
Organization
INTEGRATED MEDICINE AND CHIROPRACTIC REGENERATION CENTER O
Active
Other names
IMAC Regeneration Center of St. Louis
Organization subpart
No
Provider details
NPI number
Authorized official
THERESA LUECKE (HUMAN RESOURCES)
(270) 554-5114
Entity
Organization
Contact information
Practice address
13353 OLIVE BLVD, CHESTERFIELD, MO 63017-3108
(314) 200-4955
(314) 682-6001
Mailing address
2725 JAMES SANDERS BLVD, SUITE A, PADUCAH, KY 42001-8401
(314) 200-4955
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
—
NULL
111N00000X
Chiropractor
—
—
111NX0800X
Orthopedic Chiropractor
—
NULL
111NX0800X
Orthopedic Chiropractor
—
—
207L00000X
Anesthesiology Physician
—
NULL
207L00000X
Anesthesiology Physician
—
—
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
—
NULL
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
—
—
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
—
NULL
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
—
—
208100000X
Physical Medicine & Rehabilitation Physician
—
NULL
208100000X
Physical Medicine & Rehabilitation Physician
—
—
208VP0000X
Pain Medicine Physician
—
NULL
208VP0000X
Pain Medicine Physician
—
—
225100000X
Physical Therapist
—
NULL
225100000X
Physical Therapist
—
—
225700000X
Massage Therapist
—
NULL
225700000X
Massage Therapist
—
—
225X00000X
Occupational Therapist
—
NULL
225X00000X
Occupational Therapist
—
—
227800000X
Certified Respiratory Therapist
—
NULL
227800000X
Certified Respiratory Therapist
—
—
363AM0700X
Medical Physician Assistant
—
NULL
363AM0700X
Medical Physician Assistant
—
—
363LP2300X
Primary Care Nurse Practitioner
—
NULL
363LP2300X
Primary Care Nurse Practitioner
—
—
363LX0106X
Occupational Health Nurse Practitioner
—
NULL
363LX0106X
Occupational Health Nurse Practitioner
—
—
Other
Enumeration date
01/26/2016
Last updated
08/19/2020
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