Provider Demographics
NPI:1922171974
Name:MEYER, DONNA L (DC)
Entity Type:Individual
Prefix:DR
First Name:DONNA
Middle Name:L
Last Name:MEYER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:DONNA
Other - Middle Name:L
Other - Last Name:SEVERIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:731 HASTINGS ST.
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:MO
Mailing Address - Zip Code:65712-1077
Mailing Address - Country:US
Mailing Address - Phone:417-466-7166
Mailing Address - Fax:417-466-7591
Practice Address - Street 1:731 HASTINGS ST.
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:MO
Practice Address - Zip Code:65712-1077
Practice Address - Country:US
Practice Address - Phone:417-466-7166
Practice Address - Fax:417-466-7591
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO6602111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor