Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 2011032370 | MO |
NPI | 1003190364 |
---|---|
Provider Name | Dr. Anthony Pasek |
First Address | Manchester, MO 63021-5493 |
Second Address | Manchester, MO 63021-5493 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/10/2011 |
Last Update Date | 26/01/2017 |