MEDICARE: MASHALA TOLBERT DC

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	2025002732	MO

General Provider Information

NPI Number	:	1649070160
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MASHALA TOLBERT DC

Provider Business Mailing Address
First Line	:	2525 NW SOUTH OUTER RD STE C
Second Line	:
City	:	BLUE SPRINGS
State	:	MO
Zip	:	64015-1726
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2525 NW SOUTH OUTER RD STE C
Second Line	:
City	:	BLUE SPRINGS
State	:	MO
Zip	:	64015-1726
Country	:	US
Telephone Number	:	816-800-8305
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/14/2025
Last Update Date	:	03/14/2025

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Directions to “ MASHALA TOLBERT DC” Practice Location

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