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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