Healthcare Provider Details

I. General information

NPI: 1205068004
Provider Name (Legal Business Name): NON SURGICAL SPINE CARE, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/13/2009
Last Update Date: 08/13/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

356 SANTA FE SUITE B
LEAVENWORTH KS
66048
US

IV. Provider business mailing address

8355 NW BARRYBROOKE DR
KANSAS CITY MO
64151-1024
US

V. Phone/Fax

Practice location:
  • Phone: 913-682-4848
  • Fax:
Mailing address:
  • Phone: 816-741-0018
  • Fax: 816-741-0659

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081N0008X
TaxonomyNeuromuscular Medicine (Physical Medicine & Rehabilitation) Physician
License Number05-31479
License Number StateKS

VIII. Authorized Official

Name: MR. JOHN THOMAS BRITTON
Title or Position: MANAGER
Credential:
Phone: 816-741-0018