Mallory Leeann Dye, DC
Individual provider Active NPI Chiropractor · Poplar Bluff, MO
NPI 1952137341 · NPPES record last updated Sep 11, 2024
Key facts
- NPI
- 1952137341
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 2024035972 (MO)
- Practice address
- 1907 N Westwood Blvd
Poplar Bluff, MO 63901-2807 - Phone
- (573) 772-5451
- NPI assigned
- Sep 11, 2024
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2024035972 | MO | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Visiting Nurse Association of Southeast Missouri Inc | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 2024035972 | MO | Yes |
Addresses
Primary practice location
1907 N Westwood Blvd
Poplar Bluff, MO 63901-2807
Mailing address
6746 Heritage Dr
Poplar Bluff, MO 63901-8659
Other providers in Poplar Bluff, MO
- Megan K Dunkin
- Karra Dunn
- Nicole Dunn
- Corinne Durner
- Derry Dean Dye Jr.
- E & D Drugs,Inc.
- Jennifer Eads
- Shari Eads
- Regina Kay Eagle
- Kira Ruth Earls
All providers in Poplar Bluff, MO · Chiropractor in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 11, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.