Organization
KMO WELLNESS 1, LLC
Active
Other names
Modern Acupuncture
Organization subpart
No
Provider details
NPI number
Authorized official
RYAN VANDERPOL (FRANCHISE OWNER)
(605) 376-8737
Entity
Organization
Contact information
Practice address
12133 MANCHESTER RD, DES PERES, MO 63131-4310
(605) 376-8737
Mailing address
12133 MANCHESTER RD, DES PERES, MO 63131-4310
(605) 376-8737
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
—
—
Other
Enumeration date
09/16/2020
Last updated
04/24/2021
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