Healthcare Provider Details

I. General information

NPI: 1427386820
Provider Name (Legal Business Name): DANIELLE PEEBLES D,C,
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/23/2009
Last Update Date: 11/23/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

71 CENTRE POINTE DR
SAINT PETERS MO
63304-8579
US

IV. Provider business mailing address

71 CENTRE POINTE DR
SAINT PETERS MO
63304-8579
US

V. Phone/Fax

Practice location:
  • Phone: 314-607-9150
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NI0900X
TaxonomyInternist Chiropractor
License Number2009035691
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: