Healthcare Provider Details

I. General information

NPI: 1518405562
Provider Name (Legal Business Name): DOBSCH CHIROPRACTIC AND FAMILY WELLNESS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/09/2017
Last Update Date: 08/01/2023
Certification Date: 08/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 S TWO ST
MARTHASVILLE MO
63357-4029
US

IV. Provider business mailing address

200 S TWO ST
MARTHASVILLE MO
63357-4029
US

V. Phone/Fax

Practice location:
  • Phone: 636-229-1825
  • Fax: 636-283-6260
Mailing address:
  • Phone: 636-390-1878
  • Fax: 636-283-6260

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number2017001188
License Number StateMO

VIII. Authorized Official

Name: DR. SAMANTHA LEE ROSE DOBSCH
Title or Position: PRIMARY CHIROPRACTOR
Credential: DC
Phone: 636-229-1825