Healthcare Provider Details

I. General information

NPI: 1144251737
Provider Name (Legal Business Name): MARY KATHLEEN KUHN D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MARY KATHLEEN DEJOY

II. Dates (important events)

Enumeration Date: 07/05/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 W PEARCE BLVD
WENTZVILLE MO
63385-1418
US

IV. Provider business mailing address

120 W PEARCE BLVD
WENTZVILLE MO
63385-1418
US

V. Phone/Fax

Practice location:
  • Phone: 636-327-4752
  • Fax: 636-327-5902
Mailing address:
  • Phone: 636-327-4752
  • Fax: 636-327-5902

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCE005658
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: