Provider Demographics
NPI:1023345311
Name:NATURAL RESTORATION AND WOMEN'S HEALTH CENTER
Entity type:Organization
Organization Name:NATURAL RESTORATION AND WOMEN'S HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:G
Authorized Official - Last Name:HARPELL
Authorized Official - Suffix:
Authorized Official - Credentials:DC, PT
Authorized Official - Phone:314-856-2565
Mailing Address - Street 1:2303 MCKELVEY RD
Mailing Address - Street 2:
Mailing Address - City:MARYLAND HEIGHTS
Mailing Address - State:MO
Mailing Address - Zip Code:63043-1531
Mailing Address - Country:US
Mailing Address - Phone:314-878-9355
Mailing Address - Fax:
Practice Address - Street 1:2303 MCKELVEY RD
Practice Address - Street 2:
Practice Address - City:MARYLAND HEIGHTS
Practice Address - State:MO
Practice Address - Zip Code:63043-1531
Practice Address - Country:US
Practice Address - Phone:314-878-9355
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-09
Last Update Date:2009-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3372111N00000X
MO2004032527225100000X
SC5740225100000X
MO2007029215111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty