Provider Demographics
NPI:1992047435
Name:A L DOROUGH ENTERPRISES INC
Entity type:Organization
Organization Name:A L DOROUGH ENTERPRISES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/ CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:LOUIS
Authorized Official - Last Name:DOROUGH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:314-605-3204
Mailing Address - Street 1:173 LONG RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63005-1255
Mailing Address - Country:US
Mailing Address - Phone:314-605-3204
Mailing Address - Fax:636-532-4221
Practice Address - Street 1:173 LONG RD
Practice Address - Street 2:SUITE 100
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63005-1255
Practice Address - Country:US
Practice Address - Phone:314-605-3204
Practice Address - Fax:636-532-4221
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:A L DOROUGH ENTERPRISES INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-03-22
Last Update Date:2013-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2013002144111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1639419401OtherNPPES