Provider Demographics
NPI:1548378953
Name:KREUTER, MARY CATHERINE (DC)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:CATHERINE
Last Name:KREUTER
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 1:7734 WATSON RD
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63119-5407
Mailing Address - Country:US
Mailing Address - Phone:314-968-9913
Mailing Address - Fax:314-961-9931
Practice Address - Street 1:7734 WATSON RD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63119-5407
Practice Address - Country:US
Practice Address - Phone:314-968-9913
Practice Address - Fax:314-961-9931
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-26
Last Update Date:2007-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2000164012111N00000X
IL111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor