Provider Demographics
NPI:1073536314
Name:QUIBELL, DAVID TODD (DC)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:TODD
Last Name:QUIBELL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1057
Mailing Address - Street 2:
Mailing Address - City:WARRENSBURG
Mailing Address - State:MO
Mailing Address - Zip Code:64093-1057
Mailing Address - Country:US
Mailing Address - Phone:660-747-7171
Mailing Address - Fax:
Practice Address - Street 1:20 NW OO HWY
Practice Address - Street 2:
Practice Address - City:WARRENSBURG
Practice Address - State:MO
Practice Address - Zip Code:64093-7423
Practice Address - Country:US
Practice Address - Phone:660-747-7171
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2008-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO006208111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOU47460Medicare UPIN
MO0005888Medicare ID - Type Unspecified