Individual
DR. KIMBERLY ANN JACQUIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.C.
Contact information
Practice address
118 UNION PLAZA DRIVE, UNION, MO 63084
(636) 583-1380
(636) 583-1588
Mailing address
PO BOX 148, UNION, MO 63084-0148
(636) 583-1380
(636) 583-1588
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2003011572
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
117965
BLUE CROSS PIN
MO
01
—
177965
BLUE CROSS BLUE SHIELD
MO
01
—
186599
CARPENTERS
MO
01
—
541250
HEALTHLINK
MO
01
—
656115
UNITED HEALTHCARE
MO
01
—
P00121266
RAILROAD MEDICARE PIN
MO
Enumeration date
12/14/2006
Last updated
09/05/2008
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