Provider Demographics
NPI:1225096910
Name:BARTELS, AMY M (DC)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:M
Last Name:BARTELS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:AMY
Other - Middle Name:M
Other - Last Name:ZIMMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:11705 DORSETT RD STE 101
Mailing Address - Street 2:
Mailing Address - City:MARYLAND HEIGHTS
Mailing Address - State:MO
Mailing Address - Zip Code:63043-2519
Mailing Address - Country:US
Mailing Address - Phone:314-291-3666
Mailing Address - Fax:314-291-3668
Practice Address - Street 1:11705 DORSETT RD STE 101
Practice Address - Street 2:
Practice Address - City:MARYLAND HEIGHTS
Practice Address - State:MO
Practice Address - Zip Code:63043-2519
Practice Address - Country:US
Practice Address - Phone:314-291-3666
Practice Address - Fax:314-291-3668
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-02
Last Update Date:2018-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOCE 006410111N00000X
MO006410111NX0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0100XChiropractic ProvidersChiropractorOccupational Health
No111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO7260OtherBLUECROSS/BLUESHIELD
MOU61602Medicare UPIN
MO000031445Medicare ID - Type Unspecified