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Organization

FAMILY WELLNESS CHIROPRACTIC, LCC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. CARRIE ANN JARDINE DC (OWNER/MANAGER)
(636) 527-5970
Entity
Organization

Contact information

Practice address
355 OZARK TRAIL DR STE 9, CLAYTON-CLARKSON CENTER, ELLISVILLE, MO 63011-2164
(636) 527-5071
Mailing address
355 OZARK TRAIL DR STE 9, CLAYTON-CLARKSON CENTER, ELLISVILLE, MO 63011-2164
(636) 527-5071

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2005014052
MO
261Q00000X
Clinic/Center
2005014052
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1649471988
NPI
MO
Enumeration date
10/10/2007
Last updated
10/10/2007
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