MEDICARE: DR. MILES DAVID PAGE D.C.

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	1999137888	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	29565035	OTHER	MO	BCBS

General Provider Information

NPI Number	:	1851383541
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MILES DAVID PAGE D.C.

Provider Business Mailing Address
First Line	:	1436 SW EAGLES PARKWAY
Second Line	:
City	:	GRAIN VALLEY
State	:	MO
Zip	:	64029-9455
Country	:	US
Telephone Number	:	816-228-6912
Fax Number	:	816-867-2029

Provider Business Practice Location Address
First Line	:	1436 W AA HWY
Second Line	:
City	:	GRAIN VALLEY
State	:	MO
Zip	:	64029-9455
Country	:	US
Telephone Number	:	816-867-2026
Fax Number	:	816-867-2029

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

Provider Enumeration Date	:	08/18/2005
Last Update Date	:	07/08/2007

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