Individual
DR. GREGORY WADE EDSTROM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
5714 S LINDBERGH BLVD, #7, AFFTON, MO 63123-6955
(314) 842-4929
(314) 842-1829
Mailing address
5714 S LINDBERGH BLVD, #7, AFFTON, MO 63123-6955
(314) 842-4929
(314) 842-1829
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
03699
MO
Other
Enumeration date
03/05/2007
Last updated
07/08/2007
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