Provider Demographics
NPI:1316935398
Name:370 CHIROPRACTIC
Entity type:Organization
Organization Name:370 CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:M
Authorized Official - Last Name:ERWIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:636-925-3933
Mailing Address - Street 1:3737 ELM ST
Mailing Address - Street 2:
Mailing Address - City:SAINT CHARLES
Mailing Address - State:MO
Mailing Address - Zip Code:63301-4345
Mailing Address - Country:US
Mailing Address - Phone:636-925-3933
Mailing Address - Fax:636-925-8338
Practice Address - Street 1:3737 ELM ST
Practice Address - Street 2:
Practice Address - City:SAINT CHARLES
Practice Address - State:MO
Practice Address - Zip Code:63301-4345
Practice Address - Country:US
Practice Address - Phone:636-925-3933
Practice Address - Fax:636-925-8338
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20000170042111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty