Lauren Alison Medina, DC

Individual provider Active NPI Chiropractor · Wildwood, MO

NPI 1699314880 · NPPES record last updated Jan 5, 2020

Key facts

NPI
1699314880
Entity type
Individual (NPI type 1)
Primary specialty
Chiropractor 111N00000X
License
2020000337 (MO)
Practice address
17197 New College Ave
Wildwood, MO 63040-1100
Phone
(636) 273-4800
NPI assigned
Jan 5, 2020
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

Practice roles

OrganizationSpecialtyStatusNew patients
212 Degrees of Wellness, LLC Current
since Jan 12, 2020
Accepting new patients

Locations

17197 New College Ave
#212
Wildwood, MO 63040
Phone (636) 273-4800

17197 New College Ave
Wildwood, MO 63040
Phone (636) 273-4800

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2020000337 MO Yes

Addresses

Primary practice location

17197 New College Ave
Wildwood, MO 63040-1100

Mailing address

1756 Wilmes Rd
Wentzville, MO 63385-3024

Other providers in Wildwood, MO

All providers in Wildwood, MO · Chiropractor in Missouri

Sources for this page

Verify at the official NPI Registry.