# WILMINGTON CHIROPRACTIC CLINIC, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1609383900
- **Authorized official:** DR. MICHAEL FISCELLA DC (OWNER)
- **Authorized official phone:** (314) 353-1477

## Contact information

- **Practice address:** 4918 WEBER RD, SAINT LOUIS, MO 63123-5645
- **Practice address phone:** (314) 353-1477
- **Practice address fax:** (314) 631-3060
- **Mailing address:** 4918 WEBER RD, SAINT LOUIS, MO 63123-5645
- **Mailing address phone:** (314) 353-1477
- **Mailing address fax:** (314) 631-3060

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | 004167 | MO | Yes |

## Other

- **Enumeration date:** 01/08/2018
- **Last updated:** 01/08/2018