Individual
JOHNATHAN LIPE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
8853 LADUE RD, SAINT LOUIS, MO 63124-2309
(314) 328-7960
Mailing address
1104 REDDICK ST, PERRYVILLE, MO 63775-2922
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2023001638
MO
Other
Enumeration date
04/25/2023
Last updated
04/25/2023
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