1518405562 NPI number — DOBSCH CHIROPRACTIC AND FAMILY WELLNESS, LLC

Table of content: (NPI 1518405562)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1518405562 NPI number — DOBSCH CHIROPRACTIC AND FAMILY WELLNESS, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DOBSCH CHIROPRACTIC AND FAMILY WELLNESS, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1518405562
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/01/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
200 S TWO ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MARTHASVILLE
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
63357-4029
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
636-390-1878
Provider Business Mailing Address Fax Number:
636-283-6260

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
200 S TWO ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MARTHASVILLE
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
63357-4029
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
636-229-1825
Provider Business Practice Location Address Fax Number:
636-283-6260
Provider Enumeration Date:
02/09/2017

Additional Information

Authorized Official

Authorized Official Last Name:
DOBSCH
Authorized Official First Name:
SAMANTHA
Authorized Official Middle Name:
LEE ROSE
Authorized Official Title or Position:
PRIMARY CHIROPRACTOR
Authorized Official Telephone Number:
636-229-1825

Provider Taxonomy Codes

  • Taxonomy code: 261QH0100X , with the licence number:  2017001188 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2024 www.npivalidator.com