Provider Demographics
NPI:1073851218
Name:BONE & JOINT CHIROPRACTIC, LLC
Entity Type:Organization
Organization Name:BONE & JOINT CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:LYNNE
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHMIDT-BARLOW
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:314-628-5200
Mailing Address - Street 1:1000 DES PERES RD
Mailing Address - Street 2:STE 120
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63131-2050
Mailing Address - Country:US
Mailing Address - Phone:314-628-5200
Mailing Address - Fax:314-628-5331
Practice Address - Street 1:1000 DES PERES RD
Practice Address - Street 2:STE 120
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63131-2050
Practice Address - Country:US
Practice Address - Phone:314-628-5200
Practice Address - Fax:314-628-5331
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-23
Last Update Date:2013-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO111N00000X
MO1999139405111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty