Provider Demographics
NPI:1003616004
Name:BOHNERT, ARIELLE M
Entity type:Individual
Prefix:
First Name:ARIELLE
Middle Name:M
Last Name:BOHNERT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1706 PAUL REVERE DR
Mailing Address - Street 2:
Mailing Address - City:CAPE GIRARDEAU
Mailing Address - State:MO
Mailing Address - Zip Code:63701-1525
Mailing Address - Country:US
Mailing Address - Phone:573-382-0253
Mailing Address - Fax:
Practice Address - Street 1:1424 KURRE LN
Practice Address - Street 2:
Practice Address - City:CAPE GIRARDEAU
Practice Address - State:MO
Practice Address - Zip Code:63701-2254
Practice Address - Country:US
Practice Address - Phone:573-334-0100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-18
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2020013193111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor