Healthcare Provider Details

I. General information

NPI: 1003068164
Provider Name (Legal Business Name): APPLIED DIAGNOSTIC SERVICES-KC, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/21/2008
Last Update Date: 10/21/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8600 WARD PKWY SUITE 2075
KANSAS CITY MO
64114-2614
US

IV. Provider business mailing address

8600 WARD PKWY SUITE 2075
KANSAS CITY MO
64114-2614
US

V. Phone/Fax

Practice location:
  • Phone: 816-569-6555
  • Fax: 816-569-6556
Mailing address:
  • Phone: 816-569-6555
  • Fax: 816-569-6556

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NI0900X
TaxonomyInternist Chiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. TERRY JO NELSON
Title or Position: OWNER
Credential: DC, DABCI
Phone: 816-569-6555