Provider Demographics
NPI:1659316263
Name:WESTERFIELD, DENA MICHELE (DC)
Entity Type:Individual
Prefix:
First Name:DENA
Middle Name:MICHELE
Last Name:WESTERFIELD
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:PO BOX 1137
Mailing Address - Street 2:
Mailing Address - City:BALLWIN
Mailing Address - State:MO
Mailing Address - Zip Code:63022-1137
Mailing Address - Country:US
Mailing Address - Phone:636-527-2608
Mailing Address - Fax:636-527-4706
Practice Address - Street 1:920 KEHRS MILL ROAD
Practice Address - Street 2:
Practice Address - City:BALLWIN
Practice Address - State:MO
Practice Address - Zip Code:63011
Practice Address - Country:US
Practice Address - Phone:636-527-2608
Practice Address - Fax:636-527-4706
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-18
Last Update Date:2008-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2004018066111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO193057OtherBLUE CROSS PIN
MO666078OtherUNITED HEALTHCARE PIN
MO9346563OtherPHCS PIN
MO666078OtherUNITED HEALTHCARE PIN
MO9346563OtherPHCS PIN