Healthcare Provider Details

I. General information

NPI: 1821876970
Provider Name (Legal Business Name): CALEB JOHN OSBORN DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/19/2023
Last Update Date: 10/02/2024
Certification Date: 10/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1860 N CHURCH RD
LIBERTY MO
64068-7179
US

IV. Provider business mailing address

22120 MIDLAND DR STE 1
SHAWNEE KS
66226-3554
US

V. Phone/Fax

Practice location:
  • Phone: 816-368-8226
  • Fax:
Mailing address:
  • Phone: 913-745-4064
  • Fax: 913-745-4352

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2023038410
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: