Provider Demographics
NPI:1376872457
Name:DR DANA E ALTER LC
Entity Type:Organization
Organization Name:DR DANA E ALTER LC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DANA
Authorized Official - Middle Name:E
Authorized Official - Last Name:ALTER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:636-227-8888
Mailing Address - Street 1:134 ENCHANTED PARKWAY
Mailing Address - Street 2:SUITE 104
Mailing Address - City:MANCHESTER
Mailing Address - State:MO
Mailing Address - Zip Code:63021
Mailing Address - Country:US
Mailing Address - Phone:636-227-8888
Mailing Address - Fax:636-227-8888
Practice Address - Street 1:134 ENCHANTED PARKWAY
Practice Address - Street 2:SUITE 104
Practice Address - City:MANCHESTER
Practice Address - State:MO
Practice Address - Zip Code:63021
Practice Address - Country:US
Practice Address - Phone:636-227-8888
Practice Address - Fax:636-227-8888
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-18
Last Update Date:2014-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOMO6340111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO000032444OtherMEDICARE PTAN