Provider Demographics
NPI:1336470707
Name:BEUTEL, EMBER F (DC)
Entity Type:Individual
Prefix:DR
First Name:EMBER
Middle Name:F
Last Name:BEUTEL
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 1:4600 S LINDBERGH BLVD
Mailing Address - Street 2:STE 2
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63127-1831
Mailing Address - Country:US
Mailing Address - Phone:573-724-7108
Mailing Address - Fax:
Practice Address - Street 1:3239B LEMAY FERRY RD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63125-4419
Practice Address - Country:US
Practice Address - Phone:314-200-6500
Practice Address - Fax:314-200-6502
Is Sole Proprietor?:No
Enumeration Date:2010-01-24
Last Update Date:2018-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2010000897111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor