Provider Demographics
NPI:1578062899
Name:DOLES HEALTH LLC
Entity Type:Organization
Organization Name:DOLES HEALTH LLC
Other - Org Name:HEALTHSOURCE OF BALLWIN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHAD
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:DOLES
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:636-220-1007
Mailing Address - Street 1:431 LAFAYETTE CTR
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:MO
Mailing Address - Zip Code:63011-3943
Mailing Address - Country:US
Mailing Address - Phone:362-201-0076
Mailing Address - Fax:
Practice Address - Street 1:431 LAFAYETTE CTR
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:MO
Practice Address - Zip Code:63011-3943
Practice Address - Country:US
Practice Address - Phone:636-220-1007
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-02
Last Update Date:2020-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty