MEDICARE: INNATE FAMILY CHIROPRACTIC INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	2007015880	MO

General Provider Information

NPI Number	:	1245420298
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INNATE FAMILY CHIROPRACTIC INC.

Provider Business Mailing Address
First Line	:	4020 BALTIMORE AVE
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64111-2257
Country	:	US
Telephone Number	:	816-561-1500
Fax Number	:	816-561-1586

Provider Business Practice Location Address
First Line	:	4020 BALTIMORE AVE
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64111-2257
Country	:	US
Telephone Number	:	816-561-1500
Fax Number	:	816-561-1586

Authorized Official
Title or Position	:	OWNER/CHIROPRACTOR
Name	:	DR. MINDY M BROWN
Credential	:	D.C.
Telephone Number	:	816-561-1500

Provider Enumeration Date	:	07/26/2007
Last Update Date	:	12/03/2009

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