Provider Demographics
NPI:1346431277
Name:NASRALLAH, NADIM TOUFIC (MS, DC)
Entity Type:Individual
Prefix:DR
First Name:NADIM
Middle Name:TOUFIC
Last Name:NASRALLAH
Suffix:
Gender:M
Credentials:MS, DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11500 OLIVE BLVD
Mailing Address - Street 2:SUITE 112
Mailing Address - City:CREVE COEUR
Mailing Address - State:MO
Mailing Address - Zip Code:63141-7143
Mailing Address - Country:US
Mailing Address - Phone:314-997-7770
Mailing Address - Fax:
Practice Address - Street 1:11500 OLIVE BLVD
Practice Address - Street 2:SUITE 112
Practice Address - City:CREVE COEUR
Practice Address - State:MO
Practice Address - Zip Code:63141-7143
Practice Address - Country:US
Practice Address - Phone:314-997-7770
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-06
Last Update Date:2007-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO3538111NI0013X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NI0013XChiropractic ProvidersChiropractorIndependent Medical Examiner