Provider Demographics
NPI:1396404273
Name:GRAESSLE, MEGAN
Entity Type:Individual
Prefix:MS
First Name:MEGAN
Middle Name:
Last Name:GRAESSLE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 TRI COUNTY RD RD
Mailing Address - Street 2:
Mailing Address - City:META
Mailing Address - State:MO
Mailing Address - Zip Code:65058-2000
Mailing Address - Country:US
Mailing Address - Phone:573-418-5284
Mailing Address - Fax:
Practice Address - Street 1:300 TRI COUNTY RD RD
Practice Address - Street 2:
Practice Address - City:META
Practice Address - State:MO
Practice Address - Zip Code:65058-2000
Practice Address - Country:US
Practice Address - Phone:573-418-5284
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-08
Last Update Date:2022-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2021029060111N00000X
COCHR.0008422111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor