Healthcare Provider Details

I. General information

NPI: 1821316977
Provider Name (Legal Business Name): KATHLEEN DENISE PAHMEYER D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/13/2010
Last Update Date: 04/12/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9 VICTORY DR
LIBERTY MO
64068-3807
US

IV. Provider business mailing address

9 VICTORY DR
LIBERTY MO
64068-3807
US

V. Phone/Fax

Practice location:
  • Phone: 816-415-3144
  • Fax: 816-415-3199
Mailing address:
  • Phone: 816-415-3144
  • Fax: 816-415-3199

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NI0900X
TaxonomyInternist Chiropractor
License Number2010013901
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: