Provider Demographics
NPI:1093307134
Name:DUENKE, PAIGE (DC)
Entity Type:Individual
Prefix:
First Name:PAIGE
Middle Name:
Last Name:DUENKE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3618 S CLARK ST
Mailing Address - Street 2:
Mailing Address - City:MEXICO
Mailing Address - State:MO
Mailing Address - Zip Code:65265-4104
Mailing Address - Country:US
Mailing Address - Phone:573-581-0381
Mailing Address - Fax:
Practice Address - Street 1:3618 S CLARK ST
Practice Address - Street 2:
Practice Address - City:MEXICO
Practice Address - State:MO
Practice Address - Zip Code:65265-4104
Practice Address - Country:US
Practice Address - Phone:573-581-0381
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-10
Last Update Date:2021-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2021003448111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor