OrganizationActive
Integrated Medicine and Chiropractic Regeneration Center O
NPI 1306203096 · Sports Medicine (Family Medicine) Physician · Chesterfield, MO
Provider details
- NPI number
- 1306203096
- Entity type
- Organization
- Primary specialty
- Sports Medicine (Family Medicine) PhysicianAllopathic & Osteopathic Physicians
- Authorized official
- Theresa Luecke, Human Resources
Practice location
13353 Olive Blvd
Chesterfield, MO 63017-3108
Phone: (314) 200-4955
Fax: (314) 682-6001
Mailing address
2725 James Sanders Blvd
Paducah, KY 42001-8401
Registry dates
- Enumerated
- 2016-01-26
- Last updated
- 2020-08-19
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.