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General NPI Number Information
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NPI Number | 1801409982
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Entity Type | Individual
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Provider Name | JOHANNAH KOHLER DC
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Gender | Female
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Dates
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Enumeration Date | 08/28/2020
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Last Update Date | 08/28/2020
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Provider Practice Location Address
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Address Line | 8999 SAINT CHARLES ROCK RD
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City | SAINT LOUIS
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State | MO
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Zip | 63114-4260
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Country | US
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Telephone | 314-270-2595
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Fax |
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Provider Business Mailing Address
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Address Line | 728 LILAC AVE
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City | SAINT LOUIS
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State | MO
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Zip | 63119-4175
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Country | US
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Telephone | 314-827-8520
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 2020005402
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License Number State | MO
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