Provider Demographics
NPI:1023107331
Name:PUZZO, TONI MARIA (DC)
Entity type:Individual
Prefix:
First Name:TONI
Middle Name:MARIA
Last Name:PUZZO
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 1:71 CENTRE POINTE DRIVE
Mailing Address - Street 2:
Mailing Address - City:ST CHARLES
Mailing Address - State:MO
Mailing Address - Zip Code:63304-8579
Mailing Address - Country:US
Mailing Address - Phone:636-928-8664
Mailing Address - Fax:636-928-8670
Practice Address - Street 1:71 CENTRE POINTE DR
Practice Address - Street 2:
Practice Address - City:ST CHARLES
Practice Address - State:MO
Practice Address - Zip Code:63304-8579
Practice Address - Country:US
Practice Address - Phone:636-928-8664
Practice Address - Fax:636-928-8670
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2000153531111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO87726Medicare ID - Type Unspecified