Healthcare Provider Details

I. General information

NPI: 1649978149
Provider Name (Legal Business Name): JOHN ROBERT TOENJES III DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/23/2023
Last Update Date: 02/14/2024
Certification Date: 02/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1445 WENTZVILLE PKWY
WENTZVILLE MO
63385-3407
US

IV. Provider business mailing address

173 EQUESTRIAN DR
WINFIELD MO
63389-2058
US

V. Phone/Fax

Practice location:
  • Phone: 636-439-8939
  • Fax:
Mailing address:
  • Phone: 636-439-8939
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number16385
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: