Provider Demographics
NPI:1366782088
Name:SUNSET HILLS FAMILY CHIROPRACTIC LLC
Entity type:Organization
Organization Name:SUNSET HILLS FAMILY CHIROPRACTIC LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRITTANY
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:WARREN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:314-729-0027
Mailing Address - Street 1:4600 SOUTH LINDBERGH AVE
Mailing Address - Street 2:SUITE 3
Mailing Address - City:ST. LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63127
Mailing Address - Country:US
Mailing Address - Phone:314-729-0027
Mailing Address - Fax:314-729-1015
Practice Address - Street 1:4600 SOUTH LINDBERGH AVE
Practice Address - Street 2:SUITE 3
Practice Address - City:ST. LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63127
Practice Address - Country:US
Practice Address - Phone:314-729-0027
Practice Address - Fax:314-729-1015
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-15
Last Update Date:2013-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO212041149261Q00000X
MO2012041149111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Single Specialty