Healthcare Provider Details

I. General information

NPI: 1114069770
Provider Name (Legal Business Name): HUGO VIVIER GIBSON D.C., P.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/12/2007
Last Update Date: 12/14/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1801 NW KILLARNEY LN
LEES SUMMIT MO
64081-1606
US

IV. Provider business mailing address

1801 NW KILLARNEY LN
LEES SUMMIT MO
64081-1606
US

V. Phone/Fax

Practice location:
  • Phone: 816-525-4086
  • Fax: 816-525-3103
Mailing address:
  • Phone: 816-525-4086
  • Fax: 816-525-3103

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number5440
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: