Provider Demographics
NPI:1396344958
Name:ALDRIDGE, NOAH ADAM (DC)
Entity type:Individual
Prefix:DR
First Name:NOAH
Middle Name:ADAM
Last Name:ALDRIDGE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2745 HIGH RIDGE BLVD STE 5B
Mailing Address - Street 2:
Mailing Address - City:HIGH RIDGE
Mailing Address - State:MO
Mailing Address - Zip Code:63049-2200
Mailing Address - Country:US
Mailing Address - Phone:314-471-8903
Mailing Address - Fax:
Practice Address - Street 1:2745 HIGH RIDGE BLVD STE 5B
Practice Address - Street 2:
Practice Address - City:HIGH RIDGE
Practice Address - State:MO
Practice Address - Zip Code:63049-2200
Practice Address - Country:US
Practice Address - Phone:314-471-8903
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-23
Last Update Date:2020-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2020029495111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor