# NORTH COUNTY REHAB, D.C., LLC

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

## Provider details

- **NPI number:** 1689975252
- **Authorized official:** DR. JACOB H UTTERBACK D.C. (CHIROPRACTOR/MEMBER)
- **Authorized official phone:** (314) 551-0000

## Contact information

- **Practice address:** 350C VILLAGE SQUARE DR, SUITE 1, HAZELWOOD, MO 63042-1800
- **Practice address phone:** (314) 551-0000
- **Mailing address:** 350C VILLAGE SQUARE DR, SUITE 1, HAZELWOOD, MO 63042-1800
- **Mailing address phone:** (314) 551-0000

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | 2007000279 | MO | Yes |
| 261QM2500X | Medical Specialty Clinic/Center | CE006295 | MO | — |

## Other

- **Enumeration date:** 11/12/2010
- **Last updated:** 11/12/2010