Healthcare Provider Details

I. General information

NPI: 1891951604
Provider Name (Legal Business Name): ZAK CHIROPRACTIC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2008
Last Update Date: 07/31/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

208 SE 3RD ST
LEES SUMMIT MO
64063-2762
US

IV. Provider business mailing address

208 SE 3RD ST
LEES SUMMIT MO
64063-2762
US

V. Phone/Fax

Practice location:
  • Phone: 816-525-9900
  • Fax: 816-525-9578
Mailing address:
  • Phone: 816-525-9900
  • Fax: 816-525-9578

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NI0013X
TaxonomyIndependent Medical Examiner Chiropractor
License Number5364
License Number StateMO

VIII. Authorized Official

Name: DR. DAVID STANLEY ZAK
Title or Position: MEMBER
Credential: D.C.
Phone: 816-525-9900