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General NPI Number Information
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NPI Number | 1265751606
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Entity Type | Organization
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Legal Business Name | POEHLEIN CHIROPRACTIC WELLNESS LLC
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Dates
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Enumeration Date | 05/25/2010
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Last Update Date | 05/25/2010
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Provider Practice Location Address
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Address Line | 5013 GLENCAIRN DR
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City | COLUMBIA
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State | MO
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Zip | 65203-5104
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Country | US
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Telephone | 573-808-3101
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Fax |
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Provider Business Mailing Address
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Address Line | 5013 GLENCAIRN DR
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City | COLUMBIA
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State | MO
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Zip | 65203-5104
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Country | US
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Telephone | 573-808-3101
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Fax |
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Authorized Official
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Title or Position | OWNER/CEO
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Name | DR. ERIC ROBERT POEHLEIN
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Credential | D.C., M.B.A.
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Telephone | 573-808-3101
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 2010008817
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License Number State | MO
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