Healthcare Provider Details

I. General information

NPI: 1083240477
Provider Name (Legal Business Name): HEALING HANDS FAMILY CHIROPRACTOR
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/17/2020
Last Update Date: 03/17/2020
Certification Date: 03/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

616 E 63RD ST STE 106
KANSAS CITY MO
64110-3370
US

IV. Provider business mailing address

616 E 63RD ST STE 106
KANSAS CITY MO
64110-3370
US

V. Phone/Fax

Practice location:
  • Phone: 816-329-9006
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NI0013X
TaxonomyIndependent Medical Examiner Chiropractor
License Number
License Number State

VIII. Authorized Official

Name: RUBEN BRADLEY
Title or Position: CEO
Credential:
Phone: 816-329-9006