Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111NR0400X | Rehabilitation Chiropractor | 2010013424 | MO |
Y | 111NS0005X | Chiropractic Sports Physician | 2010013424 | MO |
NPI | 1316264237 |
---|---|
Provider Name | Dr. Lauren Elizabeth Hendrix |
First Address | Ellisville, MO 63011-2164 |
Second Address | Ellisville, MO 63011-2164 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/05/2010 |
Last Update Date | 08/09/2014 |