Healthcare Provider Details

I. General information

NPI: 1154402014
Provider Name (Legal Business Name): WASSE ZAFER D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/18/2006
Last Update Date: 11/23/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11902 BLUE RIDGE EXT
GRANDVIEW MO
64030-1100
US

IV. Provider business mailing address

11902 BLUE RIDGE EXT
GRANDVIEW MO
64030-1100
US

V. Phone/Fax

Practice location:
  • Phone: 816-808-9900
  • Fax:
Mailing address:
  • Phone: 816-808-9900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NN0400X
TaxonomyNeurology Chiropractor
License Number2015027609
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: