Healthcare Provider Details

I. General information

NPI: 1326373085
Provider Name (Legal Business Name): ELITE CHIROPRACTIC CLINIC INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/13/2009
Last Update Date: 10/13/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8357 NW BARRYBROOKE DR
KANSAS CITY MO
64151-1024
US

IV. Provider business mailing address

8357 NW BARRYBROOKE DR
KANSAS CITY MO
64151-1024
US

V. Phone/Fax

Practice location:
  • Phone: 816-741-0018
  • Fax: 816-741-0659
Mailing address:
  • Phone: 816-741-0018
  • Fax: 816-741-0659

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number2008003129
License Number StateMO

VIII. Authorized Official

Name: MR. JOHN THOMAS BRITTON
Title or Position: PRESIDENT
Credential:
Phone: 816-741-0018