Provider Demographics
NPI:1487978664
Name:POEHLEIN, ERIC ROBERT (DC)
Entity type:Individual
Prefix:DR
First Name:ERIC
Middle Name:ROBERT
Last Name:POEHLEIN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:30 E SOUTHAMPTON DR
Mailing Address - Street 2:105
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65203-6135
Mailing Address - Country:US
Mailing Address - Phone:573-808-3101
Mailing Address - Fax:573-777-4865
Practice Address - Street 1:30 E SOUTHAMPTON DR
Practice Address - Street 2:105
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65203-6135
Practice Address - Country:US
Practice Address - Phone:573-808-3101
Practice Address - Fax:573-777-4865
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-17
Last Update Date:2011-03-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2010008817111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor