Organization
DAVENPORT CHIROPRACTIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA DAVENPORT SMITH DC (OWNER)
(636) 614-0401
Entity
Organization
Contact information
Practice address
1278 BRYAN RD, O FALLON, MO 63366-3771
(636) 614-0401
Mailing address
1278 BRYAN RD, O FALLON, MO 63366-3771
(636) 614-0401
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2014031613
MO
Other
Enumeration date
09/24/2014
Last updated
09/24/2014
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