Provider Demographics
NPI:1922203330
Name:ALTER, DANA E (DC)
Entity Type:Individual
Prefix:DR
First Name:DANA
Middle Name:E
Last Name:ALTER
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 1:134 ENCHANTED PKWY
Mailing Address - Street 2:SUITE 104
Mailing Address - City:MANCHESTER
Mailing Address - State:MO
Mailing Address - Zip Code:63021-5495
Mailing Address - Country:US
Mailing Address - Phone:636-227-8888
Mailing Address - Fax:
Practice Address - Street 1:134 ENCHANTED PKWY STE 134
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:MO
Practice Address - Zip Code:63021-5495
Practice Address - Country:US
Practice Address - Phone:636-227-8888
Practice Address - Fax:636-227-8888
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-15
Last Update Date:2014-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOMO6340111NI0013X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NI0013XChiropractic ProvidersChiropractorIndependent Medical Examiner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO431715662Medicare ID - Type UnspecifiedFED ID