Healthcare Provider Details

I. General information

NPI: 1235910845
Provider Name (Legal Business Name): CMC CHIROPRACTIC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/10/2023
Last Update Date: 10/10/2023
Certification Date: 10/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1131 W MAIN ST STE G
BLUE SPRINGS MO
64015-3611
US

IV. Provider business mailing address

1131 W MAIN ST STE G
BLUE SPRINGS MO
64015-3611
US

V. Phone/Fax

Practice location:
  • Phone: 816-674-2693
  • Fax: 816-229-7085
Mailing address:
  • Phone: 816-674-2693
  • Fax: 816-229-7085

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code111NI0013X
TaxonomyIndependent Medical Examiner Chiropractor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code111NN0400X
TaxonomyNeurology Chiropractor
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code111NX0100X
TaxonomyOccupational Health Chiropractor
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code111NX0800X
TaxonomyOrthopedic Chiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. ASTON GOLDSWORTHY
Title or Position: CEO
Credential: DC, MSN, BC-FNP
Phone: 816-674-2693