Provider Demographics
NPI:1275959629
Name:NEWSOM, ABIGAIL (DC)
Entity Type:Individual
Prefix:DR
First Name:ABIGAIL
Middle Name:
Last Name:NEWSOM
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 OLYMPIC WAY
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERS
Mailing Address - State:MO
Mailing Address - Zip Code:63376-1664
Mailing Address - Country:US
Mailing Address - Phone:636-244-5223
Mailing Address - Fax:636-244-5224
Practice Address - Street 1:107 OLYMPIC WAY
Practice Address - Street 2:
Practice Address - City:SAINT PETERS
Practice Address - State:MO
Practice Address - Zip Code:63376-1664
Practice Address - Country:US
Practice Address - Phone:636-244-5223
Practice Address - Fax:636-244-5224
Is Sole Proprietor?:No
Enumeration Date:2014-03-10
Last Update Date:2019-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2014002112111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor