# ACTIVE FAMILY CHIROPRACTIC, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Cardinal Physical Medicine, Cardinal Chiropractic of St. Peters
- **Organization subpart:** No

## Provider details

- **NPI number:** 1891090395
- **Authorized official:** DR. RICHARD WAYNE BLALOCK JR. D.C. (MEMBER/MANAGER)
- **Authorized official phone:** (636) 352-0380

## Contact information

- **Practice address:** 235 JUNGERMANN RD STE 210, SAINT PETERS, MO 63376-5365
- **Practice address phone:** (636) 352-0380
- **Practice address fax:** (636) 352-2343
- **Mailing address:** 235 JUNGERMANN RD STE 210, SAINT PETERS, MO 63376-5365
- **Mailing address phone:** (636) 352-0380
- **Mailing address fax:** (636) 352-2343

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | 2011000744 | MO | Yes |

## Other

- **Enumeration date:** 01/14/2011
- **Last updated:** 09/03/2026