D. J. Fahnestock, D. C., P. C. | |
269 S Jefferson Ave Marshall MO 65340-2134 | |
(660) 886-6903 | |
(660) 886-6904 |
Full Name | D. J. Fahnestock, D. C., P. C. |
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Speciality | Clinic/Center |
Location | 269 S Jefferson Ave, Marshall, Missouri |
Authorized Official Name and Position | Daniel Jewell Fahnestock (PRESIDENT) |
Authorized Official Contact | 6608866903 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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D. J. Fahnestock, D. C., P. C. 269 S Jefferson Ave Marshall MO 65340-2134 Ph: (660) 886-6903 | D. J. Fahnestock, D. C., P. C. 269 S Jefferson Ave Marshall MO 65340-2134 Ph: (660) 886-6903 |
NPI Number | 1144495599 |
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Provider Enumeration Date | 04/28/2008 |
Last Update Date | 05/30/2008 |
Medicare PECOS PAC ID | 9931278504 |
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Medicare Enrollment ID | O20080522000088 |
Identifier | Type | State | Issuer |
---|---|---|---|
1144495599 | NPI | - | NPPES |
03801016 | Other | MO | BLUE CROSS BLUE SHIELD OF KC |
T73635 | Other | MO | UPIN |
115444 | Other | HEALTHLINK |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QP2300X | Clinic/center - Primary Care | 003184 (Missouri) | Primary |
Provider Name | Daniel J Fahnestock |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1548297922 PECOS PAC ID: 9032288691 Enrollment ID: I20080522000077 |
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