Healthcare Provider Details

I. General information

NPI: 1356134654
Provider Name (Legal Business Name): DHRUVAL MONIT PATEL DC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2025
Last Update Date: 05/28/2025
Certification Date: 05/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2716 FORUM BLVD STE 3
COLUMBIA MO
65203-5450
US

IV. Provider business mailing address

2716 FORUM BLVD STE 3
COLUMBIA MO
65203-5450
US

V. Phone/Fax

Practice location:
  • Phone: 573-447-6155
  • Fax:
Mailing address:
  • Phone: 573-447-6155
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2024015347
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: