Sports and Family Chiropractic

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2011001913 Issued in MO

Legal business name

SPORTS AND FAMILY CHIROPRACTIC

Practice address

2315 Technology Dr
Suite 107
O Fallon, MO 63368-7370

Phone

(636) 625-8894

Fax

(636) 625-8710

NPI assigned

Mar 9, 2011

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. David Declue, D.C.NPI 1063718732

Title

Co-Owner

Phone

(636) 625-8894

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• David Christopher Declue, D.C.

  • Chiropractor
  • O'Fallon, MO
  • NPI 1063718732
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1299628800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1304899200000",
    "number": "1255639662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2315 TECHNOLOGY DR",
            "address_2": "SUITE 107",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633687370",
            "telephone_number": "636-625-8894",
            "fax_number": "636-625-8710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2315 TECHNOLOGY DR",
            "address_2": "SUITE 107",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633687370",
            "telephone_number": "636-625-8894",
            "fax_number": "636-625-8710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPORTS AND FAMILY CHIROPRACTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-09",
        "last_updated": "2011-05-09",
        "status": "A",
        "authorized_official_last_name": "DECLUE",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "636-625-8894",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2011001913",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in O'Fallon, MO
• Providers in O'Fallon, MO by specialty
• Chiropractor in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.