Individual
JOSEPH ANTHONY DI CARLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
56 PORTWEST CT, SAINT CHARLES, MO 63303-5985
(636) 949-5700
(636) 916-3735
Mailing address
56 PORTWEST CT, SAINT CHARLES, MO 63303-5985
(636) 949-5700
(636) 916-3735
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CE005624
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
43-1768965
FEDERAL TAX ID #
MO
01
—
5662
BLUE CROSS/ BLUE SHIELD
MO
Enumeration date
10/02/2006
Last updated
09/20/2011
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