Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | CE 006410 | MO |
Y | 111NX0100X | Occupational Health | 006410 | MO |
NPI | 1225096910 |
---|---|
Provider Name | Dr. Amy M. Bartels |
First Address | Maryland Heights, MO 63043-2519 |
Second Address | Maryland Heights, MO 63043-2519 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/05/2006 |
Last Update Date | 01/05/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
7260 | BLUECROSS/BLUESHIELD (01) | MO |
U61602 | (02) | MO |