Provider Demographics
NPI:1629259833
Name:LINHARDT CHIROPRACTIC HEALTH SERVICES
Entity Type:Organization
Organization Name:LINHARDT CHIROPRACTIC HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:E
Authorized Official - Last Name:LINHARDT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:314-416-4100
Mailing Address - Street 1:4444 TELEGRAPH RD
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63129-3316
Mailing Address - Country:US
Mailing Address - Phone:314-416-4100
Mailing Address - Fax:314-416-4141
Practice Address - Street 1:4444 TELEGRAPH RD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63129-3316
Practice Address - Country:US
Practice Address - Phone:314-416-4100
Practice Address - Fax:314-416-4141
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-15
Last Update Date:2007-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO004467111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1124189246Medicare UPIN
MO1427124254Medicare UPIN