Provider Demographics
NPI:1528187754
Name:SADERLUND, FLOYD SKIP (DC)
Entity Type:Individual
Prefix:DR
First Name:FLOYD
Middle Name:SKIP
Last Name:SADERLUND
Suffix:
Gender:M
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:PO BOX 925
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63006-0925
Mailing Address - Country:US
Mailing Address - Phone:636-728-1460
Mailing Address - Fax:
Practice Address - Street 1:206 CHESTERFIELD TOWNE CTR
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63005-1257
Practice Address - Country:US
Practice Address - Phone:636-728-1460
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2001002793111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOU95055Medicare UPIN