Healthcare Provider Details

I. General information

NPI: 1528848835
Provider Name (Legal Business Name): ROBERT LEE POEPPELMEIER JR. DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/03/2023
Last Update Date: 11/18/2025
Certification Date: 11/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4352 MANCHESTER AVE
SAINT LOUIS MO
63110-2138
US

IV. Provider business mailing address

4352 MANCHESTER AVE
SAINT LOUIS MO
63110-2138
US

V. Phone/Fax

Practice location:
  • Phone: 314-531-5444
  • Fax: 314-531-0063
Mailing address:
  • Phone: 314-531-5444
  • Fax: 314-531-0063

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number2023035802
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2023035802
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: