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NPI Code Detail

MEDICARE: DR. DONALD WAYNE DICUS D.C.

MEDICARE: DR. DONALD WAYNE DICUS D.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111N00000XChiropractor2000165673MO
2111N00000XChiropractor038-008506IL

General Provider Information

NPI Number : 1942296538
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DONALD WAYNE DICUS D.C.
Provider Business Mailing Address
First Line : 2003 PLEASANT VALLEY DR
Second Line :
City : SAINT CHARLES
State : MO
Zip : 63303-3867
Country : US
Telephone Number : 636-328-5762
Fax Number :
Provider Business Practice Location Address
First Line : 2241 BLUESTONE DR
Second Line :
City : SAINT CHARLES
State : MO
Zip : 63303-6705
Country : US
Telephone Number : 636-328-5762
Fax Number : 636-925-0128
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/20/2005
Last Update Date : 10/31/2007

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Directions to “ DR. DONALD WAYNE DICUS D.C.” Practice Location

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