Lake St. Louis Chiropractic

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2007032057 Issued in MO

Legal business name

LAKE ST. LOUIS CHIROPRACTIC

Practice address

2161 West Terra Lane
Ofallon, MO 63366-2366

Phone

(636) 887-9003

Fax

(636) 327-6090

NPI assigned

Dec 27, 2007

Last updated

Feb 4, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jason C Fowler, DC

Title

Owner

Phone

(636) 887-9003

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1198713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1233705600000",
    "number": "1649454661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2161 WEST TERRA LANE",
            "city": "OFALLON",
            "state": "MO",
            "postal_code": "633662366",
            "telephone_number": "636-887-9003",
            "fax_number": "636-327-6090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2161 WEST TERRA LANE",
            "city": "OFALLON",
            "state": "MO",
            "postal_code": "633662366",
            "telephone_number": "636-887-9003",
            "fax_number": "636-327-6090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE ST. LOUIS CHIROPRACTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-27",
        "last_updated": "2009-02-04",
        "status": "A",
        "authorized_official_last_name": "FOWLER",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "636-887-9003",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2007032057",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "PENDING",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "D00754",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hattie Jane Kurk
• L & P Corp (WHARF Health Mart PHARMACY)
• L & P Corp.
• Jacqueline G Ladd, O.D.
• Ladybug Healthcare DTL, LLC
• Lakeside Counseling Services
• Lakeview Dental LLC
• Lakeview Medical Group Inc
• Amritpal Lall
• Kimberly Alice Lamzik, PT

• 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 Feb 4, 2009; 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.