Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 2008027067 | MO |
NPI | 1003064551 |
---|---|
Provider Name | Dr. Danielle Angela Spath |
First Address | Saint Louis, MO 63123-3518 |
Second Address | Saint Louis, MO 63123-3518 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/09/2008 |
Last Update Date | 15/11/2012 |