Organization
SPORTS AND FAMILY CHIROPRACTIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID DECLUE D.C. (CO-OWNER)
(636) 625-8894
Entity
Organization
Contact information
Practice address
2315 TECHNOLOGY DR, SUITE 107, O FALLON, MO 63368-7370
(636) 625-8894
(636) 625-8710
Mailing address
2315 TECHNOLOGY DR, SUITE 107, O FALLON, MO 63368-7370
(636) 625-8894
(636) 625-8710
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2011001913
MO
Other
Enumeration date
03/09/2011
Last updated
05/09/2011
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