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Individual

DR. PHILIP EDWARD WULFERT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DC

Contact information

Practice address
207 S MAIN ST, FREDERICKTOWN, MO 63645-1419
(573) 783-5530
Mailing address
207 S MAIN ST, FREDERICKTOWN, MO 63645-1419
(573) 783-5530

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CE 005627
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
118699
BLUE CROSS BLUE SHIELD
MO
01
133965
HEALTHLINK
MO
Enumeration date
10/05/2005
Last updated
07/08/2007
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