Organization
NORTH COUNTY REHAB, D.C., LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACOB H UTTERBACK D.C. (CHIROPRACTOR/MEMBER)
(314) 551-0000
Entity
Organization
Contact information
Practice address
350C VILLAGE SQUARE DR, SUITE 1, HAZELWOOD, MO 63042-1800
(314) 551-0000
Mailing address
350C VILLAGE SQUARE DR, SUITE 1, HAZELWOOD, MO 63042-1800
(314) 551-0000
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
2007000279
MO
261QM2500X
Medical Specialty Clinic/Center
CE006295
MO
Other
Enumeration date
11/12/2010
Last updated
11/12/2010
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