Provider Demographics
NPI:1083892293
Name:ABOVE & BEYOND CHIROPRACTIC, LLC
Entity Type:Organization
Organization Name:ABOVE & BEYOND CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:GLASS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:636-332-9100
Mailing Address - Street 1:1939 WENTZVILLE PKWY
Mailing Address - Street 2:SUITE 322
Mailing Address - City:WENTZVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:63385-3424
Mailing Address - Country:US
Mailing Address - Phone:636-332-9100
Mailing Address - Fax:
Practice Address - Street 1:213 CREEKSIDE OFFICE
Practice Address - Street 2:
Practice Address - City:WENTZVILLE
Practice Address - State:MO
Practice Address - Zip Code:63385-3290
Practice Address - Country:US
Practice Address - Phone:636-332-9100
Practice Address - Fax:636-332-9125
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-11
Last Update Date:2008-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2007038129111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty