Healthcare Provider Details

I. General information

NPI: 1467587667
Provider Name (Legal Business Name): JACLYN L HOELSCHER DC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/21/2007
Last Update Date: 03/02/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6034 YOUNG DR
WELDON SPRING MO
63304-9103
US

IV. Provider business mailing address

6034 YOUNG DR
WELDON SPRING MO
63304-9103
US

V. Phone/Fax

Practice location:
  • Phone: 636-329-8774
  • Fax: 636-329-8977
Mailing address:
  • Phone: 636-329-8774
  • Fax: 636-329-8977

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2003027783
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: