Provider Demographics
NPI:1043048242
Name:LING, CALVIN (DC)
Entity type:Individual
Prefix:DR
First Name:CALVIN
Middle Name:
Last Name:LING
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:402 ENCHANTED PKWY APT 304
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:MO
Mailing Address - Zip Code:63021-5541
Mailing Address - Country:US
Mailing Address - Phone:614-736-0510
Mailing Address - Fax:
Practice Address - Street 1:2821 N BALLAS RD STE 105
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63131-2314
Practice Address - Country:US
Practice Address - Phone:314-872-9955
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-22
Last Update Date:2024-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2024029190111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor