Healthcare Provider Details

I. General information

NPI: 1922203330
Provider Name (Legal Business Name): DANA E. ALTER DC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/15/2007
Last Update Date: 06/02/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

134 ENCHANTED PKWY STE 134
MANCHESTER MO
63021-5495
US

IV. Provider business mailing address

134 ENCHANTED PKWY SUITE 104
MANCHESTER MO
63021-5495
US

V. Phone/Fax

Practice location:
  • Phone: 636-227-8888
  • Fax: 636-227-8888
Mailing address:
  • Phone: 636-227-8888
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NI0013X
TaxonomyIndependent Medical Examiner Chiropractor
License NumberMO6340
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: