Provider Demographics
NPI:1497985691
Name:SAALE CHIROPRACTIC, P.C.
Entity Type:Organization
Organization Name:SAALE CHIROPRACTIC, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:B
Authorized Official - Last Name:SAALE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:314-842-1616
Mailing Address - Street 1:11339 GRAVOIS RD
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63126-3623
Mailing Address - Country:US
Mailing Address - Phone:314-842-1616
Mailing Address - Fax:314-842-5860
Practice Address - Street 1:11339 GRAVOIS RD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63126-3623
Practice Address - Country:US
Practice Address - Phone:314-842-1616
Practice Address - Fax:314-842-5860
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-22
Last Update Date:2009-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO005674261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty