Provider Demographics
NPI:1477872182
Name:GUERNSEY, CALEB (CALEB GUERNSEY)
Entity Type:Individual
Prefix:
First Name:CALEB
Middle Name:
Last Name:GUERNSEY
Suffix:
Gender:M
Credentials:CALEB GUERNSEY
Other - Prefix:
Other - First Name:CALEB
Other - Middle Name:
Other - Last Name:GUERNSEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CALEB GUERNSEY DC
Mailing Address - Street 1:1704 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BETHANY
Mailing Address - State:MO
Mailing Address - Zip Code:64424-2064
Mailing Address - Country:US
Mailing Address - Phone:660-425-3444
Mailing Address - Fax:660-425-3044
Practice Address - Street 1:1704 MAIN ST
Practice Address - Street 2:
Practice Address - City:BETHANY
Practice Address - State:MO
Practice Address - Zip Code:64424-2064
Practice Address - Country:US
Practice Address - Phone:660-425-3444
Practice Address - Fax:660-425-3044
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-19
Last Update Date:2012-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2010013285111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor