Individual
DR. JEANNINE M CLEMONS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DC
Contact information
Practice address
1629 N. WARSON RD, ST LOUIS, MO 63132
(314) 429-2929
(314) 429-4331
Mailing address
1629 N. WARSON RD, ST LOUIS, MO 63132
(314) 429-2929
(314) 429-4331
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CE-005796
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
28803
BLUE CROSS/SHIELD
MO
Enumeration date
10/03/2006
Last updated
07/09/2007
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