Provider Demographics
NPI:1699485797
Name:FIRST STOP CHIROPRACTIC LLC
Entity type:Organization
Organization Name:FIRST STOP CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIRORPACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:TONJA
Authorized Official - Middle Name:
Authorized Official - Last Name:MATTHIAS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:314-750-7361
Mailing Address - Street 1:11 MCCLURE AVE
Mailing Address - Street 2:
Mailing Address - City:ARNOLD
Mailing Address - State:MO
Mailing Address - Zip Code:63010-3574
Mailing Address - Country:US
Mailing Address - Phone:314-750-7361
Mailing Address - Fax:
Practice Address - Street 1:558 GRAVOIS RD STE 201
Practice Address - Street 2:
Practice Address - City:FENTON
Practice Address - State:MO
Practice Address - Zip Code:63026-4153
Practice Address - Country:US
Practice Address - Phone:314-574-1907
Practice Address - Fax:636-600-0670
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FIRST STOP CHIROPRACTIC LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-11-29
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty