Individual
LELA WIBBENMEYER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DC
Contact information
Practice address
2520 HIGHWAY K, O FALLON, MO 63368-6625
(636) 978-5511
Mailing address
2520 HIGHWAY K, O FALLON, MO 63368-6625
(636) 978-5511
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2011002178
MO
Other
Enumeration date
02/21/2011
Last updated
03/21/2011
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