| D. J. Fahnestock, D. C., P. C. | |
|
269 S Jefferson Ave Marshall MO 65340-2134 | |
| (660) 886-6903 | |
| (660) 886-6904 |
| Full Name | D. J. Fahnestock, D. C., P. C. |
|---|---|
| Speciality | Clinic/Center |
| Location | 269 S Jefferson Ave, Marshall, Missouri |
| Authorized Official Name and Position | Daniel Jewell Fahnestock (PRESIDENT) |
| Authorized Official Contact | 6608866903 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| D. J. Fahnestock, D. C., P. C. 269 S Jefferson Ave Marshall MO 65340-2134 Ph: (660) 886-6903 | D. J. Fahnestock, D. C., P. C. 269 S Jefferson Ave Marshall MO 65340-2134 Ph: (660) 886-6903 |
| NPI Number | 1144495599 |
|---|---|
| Provider Enumeration Date | 04/28/2008 |
| Last Update Date | 05/30/2008 |
| Medicare PECOS PAC ID | 9931278504 |
|---|---|
| Medicare Enrollment ID | O20080522000088 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144495599 | NPI | - | NPPES |
| 03801016 | Other | MO | BLUE CROSS BLUE SHIELD OF KC |
| T73635 | Other | MO | UPIN |
| 115444 | Other | HEALTHLINK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 003184 (Missouri) | Primary |
| Provider Name | Daniel J Fahnestock |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1548297922 PECOS PAC ID: 9032288691 Enrollment ID: I20080522000077 |
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