Individual
MR. KENNETH RAY TEATER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
2359 CHAMBERS RD, ST LOUIS, MO 63136
(314) 868-2220
(314) 868-2640
Mailing address
8 COUNT FREET CIRCLE, FLORISSANT, MO 63033
(314) 837-5470
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
003877
MO
Other
Enumeration date
10/24/2006
Last updated
07/08/2007
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