Provider Demographics
NPI:1891318846
Name:VOLLMER, ROSS (DC)
Entity Type:Individual
Prefix:
First Name:ROSS
Middle Name:
Last Name:VOLLMER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10655 BUSINESS 21
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:MO
Mailing Address - Zip Code:63050-5094
Mailing Address - Country:US
Mailing Address - Phone:636-789-2287
Mailing Address - Fax:636-789-3371
Practice Address - Street 1:10655 BUSINESS 21
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:MO
Practice Address - Zip Code:63050-5094
Practice Address - Country:US
Practice Address - Phone:636-789-2287
Practice Address - Fax:636-789-3371
Is Sole Proprietor?:No
Enumeration Date:2020-05-26
Last Update Date:2020-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2020012245111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor