Healthcare Provider Details

I. General information

NPI: 1023423142
Provider Name (Legal Business Name): EMILY B HURT D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/26/2014
Last Update Date: 12/01/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4122 NE VIVION RD
KANSAS CITY MO
64119-2811
US

IV. Provider business mailing address

4122 NE VIVION RD
KANSAS CITY MO
64119-2811
US

V. Phone/Fax

Practice location:
  • Phone: 816-453-3331
  • Fax:
Mailing address:
  • Phone: 816-453-3331
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2014001827
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: