Provider Demographics
NPI:1386053122
Name:DUEY CHIROPRACTIC
Entity type:Organization
Organization Name:DUEY CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER/ACTING PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:WESLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:DUEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:636-236-9614
Mailing Address - Street 1:507 ELM CROSSING CT
Mailing Address - Street 2:
Mailing Address - City:BALLWIN
Mailing Address - State:MO
Mailing Address - Zip Code:63021-7479
Mailing Address - Country:US
Mailing Address - Phone:636-236-9614
Mailing Address - Fax:636-940-9990
Practice Address - Street 1:2241 BLUESTONE DR
Practice Address - Street 2:
Practice Address - City:SAINT CHARLES
Practice Address - State:MO
Practice Address - Zip Code:63303-6705
Practice Address - Country:US
Practice Address - Phone:636-236-9614
Practice Address - Fax:636-940-9990
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-06
Last Update Date:2014-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2013013356111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Single Specialty