Provider Demographics
NPI:1194797282
Name:JUST, TODD W (DC)
Entity type:Individual
Prefix:DR
First Name:TODD
Middle Name:W
Last Name:JUST
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
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Mailing Address - Street 1:221 SPENCER RD
Mailing Address - Street 2:SUITE P
Mailing Address - City:SAINT PETERS
Mailing Address - State:MO
Mailing Address - Zip Code:63376-2438
Mailing Address - Country:US
Mailing Address - Phone:636-278-2030
Mailing Address - Fax:636-397-6115
Practice Address - Street 1:221 SPENCER RD
Practice Address - Street 2:SUITE P
Practice Address - City:SAINT PETERS
Practice Address - State:MO
Practice Address - Zip Code:63376-2438
Practice Address - Country:US
Practice Address - Phone:636-278-2030
Practice Address - Fax:636-397-6115
Is Sole Proprietor?:No
Enumeration Date:2006-02-03
Last Update Date:2012-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2005000214111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO043811368OtherUHC PROV. #
MO116608OtherMERCY PROV.#
MO696231OtherHEALTHLINK PROV. #
MO7499646OtherAETNA PROV.#
MO195810OtherBLUE CROSS PROVIDER #
MO670324OtherACN PROV.#
MO237347OtherGHP PROV. NUMBER
MA3357001Medicare PIN
MOV04164Medicare UPIN