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Individual

DR. RICHARD WAYNE BLALOCK JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
1404 TRIAD CENTER DR, SAINT PETERS, MO 63376-7351
(636) 352-0380
(636) 352-2343
Mailing address
1404 TRIAD CENTER DR, SAINT PETERS, MO 63376-7351
(636) 352-0380
(636) 352-2343

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2011000744
MO

Other

Enumeration date
01/14/2011
Last updated
03/01/2017
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