Healthcare Provider Details

I. General information

NPI: 1689067167
Provider Name (Legal Business Name): RAINTREE MEDICAL AND CHIROPRACTIC CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/09/2015
Last Update Date: 02/05/2024
Certification Date: 02/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

931 SW LEMANS LN
LEES SUMMIT MO
64082-4619
US

IV. Provider business mailing address

931 SW LEMANS LN
LEES SUMMIT MO
64082-4619
US

V. Phone/Fax

Practice location:
  • Phone: 816-623-3020
  • Fax: 816-623-3076
Mailing address:
  • Phone: 816-623-3020
  • Fax: 816-623-3076

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: BENJAMIN FLUEGGE
Title or Position: PRESIDENT
Credential: D.C.
Phone: 816-623-3020