Organization
EZELL CHIROPRACTIC LLC
Active
Other names
Ezell Chiropractic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GLENN R. EZELL D.C. (OWNER/DOCTOR)
(636) 916-0660
Entity
Organization
Contact information
Practice address
2201 1ST CAPITOL DR, SAINT CHARLES, MO 63301-5805
(636) 916-0660
Mailing address
2201 1ST CAPITOL DR, SAINT CHARLES, MO 63301-5805
(636) 916-0660
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
2013000467
MO
261QP2300X
Primary Care Clinic/Center
Primary
2013000467
MO
Other
Enumeration date
12/10/2013
Last updated
09/14/2022
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