Provider Demographics
NPI:1760760649
Name:STEFANIE SANGER, LLC
Entity Type:Organization
Organization Name:STEFANIE SANGER, LLC
Other - Org Name:CLAYTON WELLNESS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEFANIE
Authorized Official - Middle Name:ERIN
Authorized Official - Last Name:SANGER
Authorized Official - Suffix:
Authorized Official - Credentials:DC, JD
Authorized Official - Phone:314-726-4600
Mailing Address - Street 1:7751 CARONDELET AVE
Mailing Address - Street 2:SUITE 606
Mailing Address - City:CLAYTON
Mailing Address - State:MO
Mailing Address - Zip Code:63105-3316
Mailing Address - Country:US
Mailing Address - Phone:314-726-4600
Mailing Address - Fax:314-721-3992
Practice Address - Street 1:7751 CARONDELET AVE
Practice Address - Street 2:SUITE 606
Practice Address - City:CLAYTON
Practice Address - State:MO
Practice Address - Zip Code:63105-3316
Practice Address - Country:US
Practice Address - Phone:314-726-4600
Practice Address - Fax:314-721-3992
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-27
Last Update Date:2011-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2009000014111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty