Provider Demographics
NPI:1285406363
Name:CANTRELL CHIROPRACTIC, LLC
Entity type:Organization
Organization Name:CANTRELL CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:CANTRELL
Authorized Official - Last Name:HOWELL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:314-578-0477
Mailing Address - Street 1:4918 WEBER RD
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63123-5645
Mailing Address - Country:US
Mailing Address - Phone:314-353-1477
Mailing Address - Fax:
Practice Address - Street 1:4918 WEBER RD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63123-5645
Practice Address - Country:US
Practice Address - Phone:314-353-1477
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-23
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center