MEDICARE: SPINAL HEALTH CENTER 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

General Provider Information

NPI Number	:	1568959039
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SPINAL HEALTH CENTER LLC

Provider Business Mailing Address
First Line	:	7249 N OAK TRFY
Second Line	:
City	:	GLADSTONE
State	:	MO
Zip	:	64118-1852
Country	:	US
Telephone Number	:	816-436-1500
Fax Number	:

Provider Business Practice Location Address
First Line	:	7249 N OAK TRFY
Second Line	:
City	:	GLADSTONE
State	:	MO
Zip	:	64118-1852
Country	:	US
Telephone Number	:	816-436-1500
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. JEFFERY C CAMPBELL
Credential	:	DC
Telephone Number	:	816-215-3735

Provider Enumeration Date	:	04/19/2018
Last Update Date	:	04/19/2018

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Directions to “SPINAL HEALTH CENTER LLC ” Practice Location

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