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Organization
BACK & NECK CARE CENTER OF WEBSTER GROVES, LLC
Active
Organization
BACK & NECK CARE CENTER OF WEBSTER GROVES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSEPH T. LANE D.C. (OWNER)
(314) 968-4696
Entity
Organization
Contact information
Practice address
604 E LOCKWOOD AVE, WEBSTER GROVES, MO 63119-3219
(314) 968-4696
(314) 968-0484
Mailing address
604 E LOCKWOOD AVE, WEBSTER GROVES, MO 63119-3219
(314) 968-4696
(314) 968-0484
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CE004876
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
114153
HEATLTH LINK
MO
01
—
2027274
AETNA
MO
01
—
4401192
UNITED HEALTH CARE
MO
01
—
625709
ACN
MO
01
—
9360
BLUE CROSS BLUE SHIELD
MO
Enumeration date
05/13/2008
Last updated
11/04/2011
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