Provider Demographics
NPI:1912069733
Name:DANIEL G ARMBRUSTER DC PC
Entity Type:Organization
Organization Name:DANIEL G ARMBRUSTER DC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:GERARD
Authorized Official - Last Name:ARMBRUSTER
Authorized Official - Suffix:
Authorized Official - Credentials:DC DIPL AC NCCAOM
Authorized Official - Phone:314-832-3344
Mailing Address - Street 1:2730 WATSON RD
Mailing Address - Street 2:
Mailing Address - City:ST LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63139
Mailing Address - Country:US
Mailing Address - Phone:314-832-3344
Mailing Address - Fax:314-832-3833
Practice Address - Street 1:2730 WATSON RD
Practice Address - Street 2:
Practice Address - City:ST LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63139
Practice Address - Country:US
Practice Address - Phone:314-832-3344
Practice Address - Fax:314-832-3833
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-15
Last Update Date:2014-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO005929111N00000X
MO2004006935171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO990001829Medicare PIN