Provider Demographics
NPI:1912116815
Name:SPINAL CARE CONCEPTS, P.C.
Entity Type:Organization
Organization Name:SPINAL CARE CONCEPTS, P.C.
Other - Org Name:MCKELVEY CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:BALOG
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:314-878-9355
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:314-878-7219
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:314-878-7219
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2004011261111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty