Healthcare Provider Details

I. General information

NPI: 1851394043
Provider Name (Legal Business Name): KEVIN LEE BAYS D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2005
Last Update Date: 06/27/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

212 VANCE RD
LEBANON MO
65536-3664
US

IV. Provider business mailing address

212 VANCE RD
LEBANON MO
65536-3664
US

V. Phone/Fax

Practice location:
  • Phone: 417-532-6251
  • Fax: 417-532-6221
Mailing address:
  • Phone: 417-532-6251
  • Fax: 417-532-6221

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number006235
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: