Organization
JKL ENTERPRISES INC
Active
Organization
JKL ENTERPRISES INC
Active
Other names
MID RIVERS CHIROPRACTIC
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES EDWARD LUSTIG D.C. (OWNER)
(636) 279-1400
Entity
Organization
Contact information
Practice address
7472 MEXICO RD, SAINT PETERS, MO 63376-1305
(636) 279-1400
Mailing address
7472 MEXICO RD, SAINT PETERS, MO 63376-1305
(636) 279-1400
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
004440
MO
Other
Enumeration date
10/10/2011
Last updated
10/10/2011
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