Provider Demographics
NPI:1831644327
Name:ST. COEUR, ANDREW CAMERON (DC)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:CAMERON
Last Name:ST. COEUR
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 1:1434 NEW HAMPSHIRE AVE
Mailing Address - Street 2:
Mailing Address - City:MARYSVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48040-1707
Mailing Address - Country:US
Mailing Address - Phone:810-357-7735
Mailing Address - Fax:
Practice Address - Street 1:401 MCMORRAN BLVD
Practice Address - Street 2:
Practice Address - City:PORT HURON
Practice Address - State:MI
Practice Address - Zip Code:48060-3809
Practice Address - Country:US
Practice Address - Phone:810-987-4740
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-24
Last Update Date:2021-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038.012977111N00000X
MI2301010549111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor