Provider Demographics
NPI:1457492290
Name:ALTERNATIVE HEALTH & WELLNESS CENTER MID-AMERICA, INC.
Entity Type:Organization
Organization Name:ALTERNATIVE HEALTH & WELLNESS CENTER MID-AMERICA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GEOFFREY
Authorized Official - Middle Name:DONALD
Authorized Official - Last Name:NORTON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:314-961-7605
Mailing Address - Street 1:2580 JACKSON RD
Mailing Address - Street 2:
Mailing Address - City:WENTZVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:63385-4202
Mailing Address - Country:US
Mailing Address - Phone:314-961-7605
Mailing Address - Fax:
Practice Address - Street 1:23 N GORE AVE
Practice Address - Street 2:
Practice Address - City:WEBSTER GROVES
Practice Address - State:MO
Practice Address - Zip Code:63119-2300
Practice Address - Country:US
Practice Address - Phone:314-961-7605
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO6123111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO200772OtherHEALTHLINK
MO4405100OtherUNITED HEALTH CARE
MO4992OtherBLUE CROSS
MO31975Medicare ID - Type Unspecified
MO4992OtherBLUE CROSS