Provider Demographics
NPI:1801981725
Name:WALTON CS-IX INC
Entity type:Organization
Organization Name:WALTON CS-IX INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:FINK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:636-922-0777
Mailing Address - Street 1:1755 STUMP RD
Mailing Address - Street 2:
Mailing Address - City:DARDENNE PRAIRIE
Mailing Address - State:MO
Mailing Address - Zip Code:63368-6716
Mailing Address - Country:US
Mailing Address - Phone:636-922-0777
Mailing Address - Fax:636-922-0833
Practice Address - Street 1:1755 STUMP RD
Practice Address - Street 2:
Practice Address - City:DARDENNE PRAIRIE
Practice Address - State:MO
Practice Address - Zip Code:63368-6716
Practice Address - Country:US
Practice Address - Phone:636-922-0777
Practice Address - Fax:636-922-0833
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2021-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO000013938Medicare PIN