Individual
DR. DEBORAH LEE EBERT GROMMET
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
D.C.
Contact information
Practice address
1055 COMMERCIAL BLVD, HERCULANEUM, MO 63048-1415
(636) 475-4477
(636) 475-4477
Mailing address
1055 COMMERCIAL BLVD, HERCULANEUM, MO 63048-1415
(636) 475-4477
(636) 475-4477
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
005254
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1830285
TAX ID NUMBER
MO
01
—
4406400
UNITED HEALTH CARE
MO
01
—
5944
BC BS
MO
Enumeration date
06/15/2006
Last updated
07/08/2007
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