Individual
JOHN SMITH JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
249 CLARKSON RD, #101, ELLISVILLE, MO 63011-2219
(636) 256-0707
Mailing address
249 CLARKSON RD # 101, ELLISVILLE, MO 63011-2497
(636) 256-0707
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
6547
MO
Other
Enumeration date
06/30/2006
Last updated
12/20/2023
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