Provider Demographics
NPI:1952498529
Name:WEINSTOCK, LORI ANN (DC)
Entity Type:Individual
Prefix:DR
First Name:LORI
Middle Name:ANN
Last Name:WEINSTOCK
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 S BEMISTON AVE
Mailing Address - Street 2:STE 1010
Mailing Address - City:CLAYTON
Mailing Address - State:MO
Mailing Address - Zip Code:63105-1907
Mailing Address - Country:US
Mailing Address - Phone:314-725-8600
Mailing Address - Fax:314-725-8607
Practice Address - Street 1:230 S BEMISTON AVE
Practice Address - Street 2:STE 1010
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63105-1907
Practice Address - Country:US
Practice Address - Phone:314-725-8600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-06
Last Update Date:2017-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2002002428111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO157346OtherBLUE CROSS BLUE SHIELD
MO44-01160OtherUNITED HEALTH CARE
MO157346OtherBLUE CROSS BLUE SHIELD