Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 2018015902 | MO |
NPI | 1003473950 |
---|---|
Provider Name | Dr. Daniel Thomas Spitler II |
First Address | O Fallon, MO 63366-1747 |
Second Address | O Fallon, MO 63366-3771 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/05/2019 |
Last Update Date | 13/01/2020 |