Provider Demographics
NPI:1073780920
Name:KRISTINA CLAY, D.C., PC
Entity Type:Organization
Organization Name:KRISTINA CLAY, D.C., PC
Other - Org Name:CENTERPOINT CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KRISTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:CLAY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:636-379-9105
Mailing Address - Street 1:2917 HIGHWAY K
Mailing Address - Street 2:SUITE F
Mailing Address - City:O FALLON
Mailing Address - State:MO
Mailing Address - Zip Code:63368-7979
Mailing Address - Country:US
Mailing Address - Phone:636-379-9105
Mailing Address - Fax:636-379-9107
Practice Address - Street 1:2917 HIGHWAY K
Practice Address - Street 2:SUITE F
Practice Address - City:O FALLON
Practice Address - State:MO
Practice Address - Zip Code:63368-7979
Practice Address - Country:US
Practice Address - Phone:636-379-9105
Practice Address - Fax:636-379-9107
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-09
Last Update Date:2008-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO006738111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO000031656Medicare PIN
MOU73651Medicare UPIN