Provider Demographics
NPI:1407835721
Name:WEICH, DEAN M (DC)
Entity Type:Individual
Prefix:DR
First Name:DEAN
Middle Name:M
Last Name:WEICH
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 1:5960 HOWDERSHELL RD
Mailing Address - Street 2:SUITE 204
Mailing Address - City:HAZELWOOD
Mailing Address - State:MO
Mailing Address - Zip Code:63042-4100
Mailing Address - Country:US
Mailing Address - Phone:314-895-1136
Mailing Address - Fax:314-895-5040
Practice Address - Street 1:5960 HOWDERSHELL RD
Practice Address - Street 2:SUITE 204
Practice Address - City:HAZELWOOD
Practice Address - State:MO
Practice Address - Zip Code:63042-4100
Practice Address - Country:US
Practice Address - Phone:314-895-1136
Practice Address - Fax:314-895-5040
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-13
Last Update Date:2008-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO005773111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
179024OtherHEALTHLINK
MO29016OtherBCBS
MO000032240Medicare ID - Type Unspecified
U06253Medicare UPIN