Healthcare Provider Details

I. General information

NPI: 1265704688
Provider Name (Legal Business Name): JEREMY DAVIS KOBLER D.C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/31/2012
Last Update Date: 09/04/2025
Certification Date: 09/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 NW ENGLEWOOD RD
KANSAS CITY MO
64118-3960
US

IV. Provider business mailing address

500 NW ENGLEWOOD RD
KANSAS CITY MO
64118-3960
US

V. Phone/Fax

Practice location:
  • Phone: 816-569-6577
  • Fax: 816-569-6843
Mailing address:
  • Phone: 816-569-6577
  • Fax: 816-569-6843

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2012008307
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code111NP0017X
TaxonomyPediatric Chiropractor
License Number2012008307
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: