MEDICARE: DR. CHRISTINE LOUISE DUNSWORTH DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	2000146167	MO

General Provider Information

NPI Number	:	1285758268
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTINE LOUISE DUNSWORTH DC

Provider Business Mailing Address
First Line	:	4460 DELOR ST
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63116-1321
Country	:	US
Telephone Number	:	314-352-0883
Fax Number	:

Provider Business Practice Location Address
First Line	:	11426 GRAVOIS RD
Second Line	:	SUITE 203
City	:	SAINT LOUIS
State	:	MO
Zip	:	63126-3656
Country	:	US
Telephone Number	:	314-849-9255
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/17/2007
Last Update Date	:	07/08/2007

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