Individual provider · Type 1 NPI
Gregory Wade Edstrom, DC
Chiropractor · Affton, MO
NPI number
1447389119
Active
Practice location
5714 S Lindbergh Blvd, #7
Affton, MO 63123-6955
Fax (314) 842-1829
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Chiropractor Primary | 111N00000X | 03699 (MO) |
Chiropractor: A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.
Other chiropractor providers in Affton
About NPI 1447389119
Gregory Wade Edstrom, DC's National Provider Identifier is 1447389119, issued on Mar 5, 2007. The primary taxonomy on file is Chiropractor (111N00000X), and the practice location is in Affton, MO. The record was last updated on Jul 8, 2007.