Individual
DR. ASHLEY LAUREN LANE-BRUNJES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.C.
Contact information
Practice address
108 FRONT STREET, SUITE 101, LABADIE, MO 63055-1301
(636) 742-3733
(636) 742-3633
Mailing address
117 FRONT ST, LABADIE, MO 63055-1236
(636) 742-3733
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2008010491
MO
111NP0017X
Pediatric Chiropractor
2008010491
MO
111NS0005X
Sports Physician Chiropractor
2008010491
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000589812
BSBC/ANTHEM ID#
—
01
—
1104363
UNITED HEALTH CARE ID#
—
01
—
11863758
CAQH ID
MO
01
—
2008010491
LICENSE #
MO
01
—
48349
ASH LINK ID#
—
01
—
9258138
AETNA ID#
—
01
—
929264
HEALTHLINK ID#
—
01
—
MA1169
MEDICARE PTAN GROUP #
MO
01
—
MA1169001
MEDICARE PTAN INDIVIDUAL #
MO
Enumeration date
04/22/2008
Last updated
09/09/2019
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