MEDICARE: ELIZABETH THORNE LLC

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	2015015202	MO

General Provider Information

NPI Number	:	1508397597
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ELIZABETH THORNE LLC

Provider Business Mailing Address
First Line	:	6264 LEWIS DR
Second Line	:	STE 101
City	:	PARKVILLE
State	:	MO
Zip	:	64152-3603
Country	:	US
Telephone Number	:	913-353-5659
Fax Number	:

Provider Business Practice Location Address
First Line	:	6264 LEWIS DR
Second Line	:	STE 101
City	:	PARKVILLE
State	:	MO
Zip	:	64152-3603
Country	:	US
Telephone Number	:	913-353-5659
Fax Number	:

Authorized Official
Title or Position	:	OWNER/CHIROPRACTOR
Name	:	ELIZABETH THORNE
Credential	:	DC
Telephone Number	:	913-353-5659

Provider Enumeration Date	:	03/22/2017
Last Update Date	:	01/02/2021

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