Doles Health LLC
Organization Active NPI Chiropractor · Manchester, MO
NPI 1578062899 · NPPES record last updated Dec 16, 2020
Key facts
- NPI
- 1578062899
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Chiropractor 111N00000X
- Legal business name
- DOLES HEALTH LLC
- Practice address
- 431 Lafayette Ctr
Manchester, MO 63011-3943 - Phone
- (636) 220-1007
- NPI assigned
- Feb 2, 2018
- Organization subpart
- No
Authorized official
- Name
- Chad Joseph Doles, DC
- Title
- President/Owner
- Phone
- (636) 220-1007
Practitioners 2
-
Chad Joseph Doles, D.C.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20201222001318 | MO | Part B Supplier - Clinic/Group Practice | 0547672206 |
Receives reassigned benefits from 1 practitioner Practice locations: Manchester, MO |
National Provider Directory
Locations
431 Lafayette Ctr
Manchester, MO 63011
Phone (636) 220-1007
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | Yes |
Addresses
Primary practice location
431 Lafayette Ctr
Manchester, MO 63011-3943
Mailing address
431 Lafayette Ctr
Manchester, MO 63011-3943
Phone (362) 201-0076
Other names
- HealthSource of Ballwin
Other providers in Manchester, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 16, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.