Healthcare Provider Details

I. General information

NPI: 1992170401
Provider Name (Legal Business Name): BUMPS & BABIES CHIROPRACTIC, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/09/2015
Last Update Date: 12/09/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 W GREGORY BLVD SUITE 315
KANSAS CITY MO
64114-1107
US

IV. Provider business mailing address

222 W GREGORY BLVD SUITE 315
KANSAS CITY MO
64114-1107
US

V. Phone/Fax

Practice location:
  • Phone: 816-361-0655
  • Fax:
Mailing address:
  • Phone: 816-361-0655
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2015032927
License Number StateMO

VIII. Authorized Official

Name: DR. HANAH JO HLAVAC
Title or Position: MEMBER
Credential: D.C.
Phone: 816-361-0655