Provider Demographics
NPI:1831717701
Name:NASH CHIROPRACTIC LLC
Entity type:Organization
Organization Name:NASH CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:DANIELLE
Authorized Official - Middle Name:E
Authorized Official - Last Name:JUNGERMANN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:314-458-9236
Mailing Address - Street 1:50 CENTRE ON THE LK
Mailing Address - Street 2:
Mailing Address - City:LAKE SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63367-2938
Mailing Address - Country:US
Mailing Address - Phone:314-458-9236
Mailing Address - Fax:
Practice Address - Street 1:10447 WALNUT LN
Practice Address - Street 2:
Practice Address - City:FORISTELL
Practice Address - State:MO
Practice Address - Zip Code:63348-2552
Practice Address - Country:US
Practice Address - Phone:314-458-9236
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-08
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center