Provider Demographics
NPI:1437648623
Name:ACKROYD, DEVON LOWELL (DC, MS, DACBSP)
Entity Type:Individual
Prefix:DR
First Name:DEVON
Middle Name:LOWELL
Last Name:ACKROYD
Suffix:
Gender:M
Credentials:DC, MS, DACBSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10279 CLAYTON RD
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63124-1115
Mailing Address - Country:US
Mailing Address - Phone:314-550-6220
Mailing Address - Fax:
Practice Address - Street 1:10279 CLAYTON RD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63124-1115
Practice Address - Country:US
Practice Address - Phone:314-390-9915
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-03
Last Update Date:2022-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2018001705111N00000X, 111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
No111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty