Provider Demographics
NPI:1154544393
Name:BONE, DAVID E (DC)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:E
Last Name:BONE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:5331 CARDINAL RIDGE CIR
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63119-5013
Mailing Address - Country:US
Mailing Address - Phone:314-962-0519
Mailing Address - Fax:314-961-9931
Practice Address - Street 1:7734 WATSON RD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63119-5407
Practice Address - Country:US
Practice Address - Phone:314-961-1807
Practice Address - Fax:314-961-9931
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO004000111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOT42820Medicare UPIN