| Utterback Chiropractic, Llc | |
|
140 W Adams Ave Kirkwood MO 63122-4023 | |
| (314) 965-8084 | |
| (314) 965-8612 |
| Full Name | Utterback Chiropractic, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 140 W Adams Ave, Kirkwood, Missouri |
| Authorized Official Name and Position | Jacob Hedges Utterback (PRESIDENT/OWNER) |
| Authorized Official Contact | 3149658084 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Utterback Chiropractic, Llc 140 W Adams Ave Kirkwood MO 63122-4023 Ph: (314) 965-8084 | Utterback Chiropractic, Llc 140 W Adams Ave Kirkwood MO 63122-4023 Ph: (314) 965-8084 |
| NPI Number | 1316174535 |
|---|---|
| Provider Enumeration Date | 06/15/2009 |
| Last Update Date | 06/15/2009 |
| Medicare PECOS PAC ID | 8729130075 |
|---|---|
| Medicare Enrollment ID | O20090716000504 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316174535 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 2007000279 (Missouri) | Primary |
| Provider Name | Jacob H Utterback |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1730228248 PECOS PAC ID: 5597856807 Enrollment ID: I20070801000043 |
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