Organization
BACK-IN-LINE WELLNESS CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHRISTOPHER ALAN UTRUP D.C. (OWNER)
(314) 750-6109
Entity
Organization
Contact information
Practice address
14 RONNIES PLZ, SAINT LOUIS, MO 63126-3552
(314) 750-6109
Mailing address
14 RONNIES PLZ, SAINT LOUIS, MO 63126-3552
(314) 750-6109
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
2007024823
MO
Other
Enumeration date
03/31/2010
Last updated
03/31/2010
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