Provider Demographics
NPI:1992939722
Name:FLORES, MIGUEL PRIETO (DC)
Entity type:Individual
Prefix:
First Name:MIGUEL
Middle Name:PRIETO
Last Name:FLORES
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 1:16607 MARCROSS CT
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63005-4824
Mailing Address - Country:US
Mailing Address - Phone:636-579-1081
Mailing Address - Fax:
Practice Address - Street 1:8403 MARYLAND AVE
Practice Address - Street 2:
Practice Address - City:CLAYTON
Practice Address - State:MO
Practice Address - Zip Code:63105-3646
Practice Address - Country:US
Practice Address - Phone:314-725-3358
Practice Address - Fax:314-725-1733
Is Sole Proprietor?:No
Enumeration Date:2009-05-07
Last Update Date:2009-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2009005334111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor