Healthcare Provider Details

I. General information

NPI: 1942029194
Provider Name (Legal Business Name): PATH-LOGICAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2024
Last Update Date: 10/10/2024
Certification Date: 10/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2612 CHESTNUT AVE
KANSAS CITY MO
64127-4046
US

IV. Provider business mailing address

2612 CHESTNUT AVE
KANSAS CITY MO
64127-4046
US

V. Phone/Fax

Practice location:
  • Phone: 816-809-6544
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State

VIII. Authorized Official

Name: ARRIN BLOUNT
Title or Position: HEALTH & WELLNESS COACH
Credential:
Phone: 816-809-6544