Provider Demographics
NPI:1821421579
Name:GIANINO CHIROPRACTIC
Entity Type:Organization
Organization Name:GIANINO CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CARISSA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:GIANINO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:417-350-4236
Mailing Address - Street 1:745 CRAIG RD
Mailing Address - Street 2:STE 208
Mailing Address - City:CREVE COEUR
Mailing Address - State:MO
Mailing Address - Zip Code:63141-7160
Mailing Address - Country:US
Mailing Address - Phone:314-877-8056
Mailing Address - Fax:
Practice Address - Street 1:745 CRAIG RD
Practice Address - Street 2:STE 208
Practice Address - City:CREVE COEUR
Practice Address - State:MO
Practice Address - Zip Code:63141-7160
Practice Address - Country:US
Practice Address - Phone:314-877-8056
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-16
Last Update Date:2013-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2012022716111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty