Provider Demographics
NPI:1932244571
Name:SPRAUL, JOHN RICHARD (DC)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:RICHARD
Last Name:SPRAUL
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 1:512 W PEARCE BLVD
Mailing Address - Street 2:
Mailing Address - City:WENTZVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:63385-1343
Mailing Address - Country:US
Mailing Address - Phone:636-327-8080
Mailing Address - Fax:636-327-8080
Practice Address - Street 1:512 W PEARCE BLVD
Practice Address - Street 2:
Practice Address - City:WENTZVILLE
Practice Address - State:MO
Practice Address - Zip Code:63385-1343
Practice Address - Country:US
Practice Address - Phone:636-327-8080
Practice Address - Fax:636-327-8080
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2012-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO003711111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
4400309OtherUHC
13646OtherBLUE CROSS BLUE SHIELD
180008OtherHEALTHLINK
887257OtherFIRST HEALTH
13646OtherBLUE CROSS BLUE SHIELD
T43201Medicare UPIN