Healthcare Provider Details

I. General information

NPI: 1336211713
Provider Name (Legal Business Name): MIDWEST CHIROPRACTIC PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/14/2006
Last Update Date: 11/14/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1416 NW STATE ROUTE 7
BLUE SPRINGS MO
64014-2238
US

IV. Provider business mailing address

1416 NW STATE ROUTE 7
BLUE SPRINGS MO
64014-2238
US

V. Phone/Fax

Practice location:
  • Phone: 816-229-6633
  • Fax: 816-229-6295
Mailing address:
  • Phone: 816-229-6633
  • Fax: 816-229-6295

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. SEAN P ROGAN
Title or Position: PRESIDENT
Credential: D.C.
Phone: 816-229-6633