MEDICARE: JOSEPH DOLL 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	2021051077	MO

General Provider Information

NPI Number	:	1720706039
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSEPH DOLL DC

Provider Business Mailing Address
First Line	:	405 ENCHANTED PKWY APT 303
Second Line	:
City	:	MANCHESTER
State	:	MO
Zip	:	63021-5540
Country	:	US
Telephone Number	:	812-881-5430
Fax Number	:

Provider Business Practice Location Address
First Line	:	2000 1ST CAPITOL DR
Second Line	:
City	:	SAINT CHARLES
State	:	MO
Zip	:	63301-1647
Country	:	US
Telephone Number	:	636-757-3744
Fax Number	:

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

Provider Enumeration Date	:	08/22/2022
Last Update Date	:	08/22/2022

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Directions to “ JOSEPH DOLL DC” Practice Location

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