Basic Information
Provider Information
NPI: 1205011285
EntityType: 2
ReplacementNPI:  
OrganizationName: MINNER & SCHEIBLE CHIROPRACTIC, LLC
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 902 E 6TH ST
Address2: SUITE B
City: WASHINGTON
State: MO
PostalCode: 630903111
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 902 E 6TH ST
Address2: SUITE B
City: WASHINGTON
State: MO
PostalCode: 630903111
CountryCode: US
TelephoneNumber: 6362399997
FaxNumber: 6362399931
Other Information
ProviderEnumerationDate: 01/08/2008
LastUpdateDate: 01/08/2008
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: MINNER
AuthorizedOfficialFirstName: MEGAN
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: PARTNER
AuthorizedOfficialTelephone: 6362399997
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: DR.
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential: D.C.
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
111N00000X  Y193400000X SINGLE SPECIALTY GROUPChiropractic ProvidersChiropractor 

No ID Information.


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