Provider Demographics
NPI:1245558360
Name:POBST, STEPHEN GREGORY (DC)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:GREGORY
Last Name:POBST
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 1:6307 HAZELWEST CT
Mailing Address - Street 2:SUITE 100
Mailing Address - City:HAZELWOOD
Mailing Address - State:MO
Mailing Address - Zip Code:63042-1761
Mailing Address - Country:US
Mailing Address - Phone:313-895-3328
Mailing Address - Fax:314-731-4832
Practice Address - Street 1:6307 HAZELWEST CT
Practice Address - Street 2:SUITE 100
Practice Address - City:HAZELWOOD
Practice Address - State:MO
Practice Address - Zip Code:63042-1761
Practice Address - Country:US
Practice Address - Phone:313-895-3328
Practice Address - Fax:314-731-4832
Is Sole Proprietor?:No
Enumeration Date:2010-05-13
Last Update Date:2010-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2010014269111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor