Healthcare Provider Details

I. General information

NPI: 1457520645
Provider Name (Legal Business Name): SARAH BETH KUCERA DC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/21/2008
Last Update Date: 05/22/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1907 WYANDOTTE ST
KANSAS CITY MO
64108-1903
US

IV. Provider business mailing address

9008 N BRITT AVE
KANSAS CITY MO
64154-2024
US

V. Phone/Fax

Practice location:
  • Phone: 816-283-3108
  • Fax:
Mailing address:
  • Phone: 816-668-5414
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2007012106
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: