Healthcare Provider Details

I. General information

NPI: 1326220294
Provider Name (Legal Business Name): KANSAS CITY CHIROPRACTIC, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/03/2007
Last Update Date: 12/03/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4210 RAINBOW BLVD
KANSAS CITY KS
66103-3113
US

IV. Provider business mailing address

4318 RAINBOW BLVD 230
KANSAS CITY KS
66103-3425
US

V. Phone/Fax

Practice location:
  • Phone: 913-789-9929
  • Fax:
Mailing address:
  • Phone: 316-269-0470
  • Fax: 561-367-1320

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number00640
License Number StateKS

VIII. Authorized Official

Name: DR. STEPHEN L PRICE
Title or Position: PRESIDENT
Credential: D.C.
Phone: 913-789-9929