Organization
FRONTIER INTEGRATED HEALTH CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAYMOND JAMES OTTOMEYER III DC (OWNER)
(636) 379-5934
Entity
Organization
Contact information
Practice address
199 FRONTIER PARK DR, O FALLON, MO 63366-3963
(636) 379-5934
(636) 410-3323
Mailing address
199 FRONTIER PARK DR, O FALLON, MO 63366-3963
(636) 379-5934
(636) 410-3323
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
—
—
207Q00000X
Family Medicine Physician
—
—
261Q00000X
Clinic/Center
Primary
112431
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
160876
BLUECROSS
MO
01
—
2576722
UNITED HEALTHCARE
MO
01
—
375245
HEALTHLINK
MO
Enumeration date
06/11/2007
Last updated
02/24/2022
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