Provider Demographics
NPI:1942993175
Name:PAIN RELIEF CHIROPRACTIC
Entity type:Organization
Organization Name:PAIN RELIEF CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:BURKS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:619-274-1571
Mailing Address - Street 1:406 JUNGERMANN RD
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERS
Mailing Address - State:MO
Mailing Address - Zip Code:63376-2764
Mailing Address - Country:US
Mailing Address - Phone:619-274-1571
Mailing Address - Fax:
Practice Address - Street 1:406 JUNGERMANN RD
Practice Address - Street 2:
Practice Address - City:SAINT PETERS
Practice Address - State:MO
Practice Address - Zip Code:63376-2764
Practice Address - Country:US
Practice Address - Phone:636-395-2852
Practice Address - Fax:636-244-1219
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-01
Last Update Date:2023-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center