Provider Demographics
NPI:1952648636
Name:LMB CHIROPRACTIC, LLC
Entity Type:Organization
Organization Name:LMB CHIROPRACTIC, LLC
Other - Org Name:SOUTH COUNTY CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:BUCK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:314-374-2523
Mailing Address - Street 1:1638 TWIN OAKS DR
Mailing Address - Street 2:
Mailing Address - City:ARNOLD
Mailing Address - State:MO
Mailing Address - Zip Code:63010-1040
Mailing Address - Country:US
Mailing Address - Phone:314-892-3602
Mailing Address - Fax:314-892-3602
Practice Address - Street 1:4582 TELEGRAPH RD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63129-3318
Practice Address - Country:US
Practice Address - Phone:314-892-3602
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-14
Last Update Date:2013-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2013000303111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty