Provider Demographics
NPI:1760528061
Name:BATES MUELLER, DEANNA K (DC)
Entity Type:Individual
Prefix:DR
First Name:DEANNA
Middle Name:K
Last Name:BATES MUELLER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:DEANNA
Other - Middle Name:K
Other - Last Name:BATES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:127 COUNTRY CREEK CT
Mailing Address - Street 2:
Mailing Address - City:BALLWIN
Mailing Address - State:MO
Mailing Address - Zip Code:63011-3811
Mailing Address - Country:US
Mailing Address - Phone:314-452-0897
Mailing Address - Fax:
Practice Address - Street 1:14377 WOODLAKE DR
Practice Address - Street 2:SUITE 110
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63017-5735
Practice Address - Country:US
Practice Address - Phone:314-628-9895
Practice Address - Fax:314-628-9874
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO006352111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO3450946OtherCIGNA
MO80770OtherGROUP HEALTH PLAN
MO44-02444OtherUNITED HEALTHCARE
MO104526OtherBLUE CROSS & BLUE SHIELD
MO3450946OtherCIGNA