Healthcare Provider Details

I. General information

NPI: 1326063983
Provider Name (Legal Business Name): ANDREW ALEX BEDELL DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2006
Last Update Date: 04/23/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

638 E YOUNG AVE
WARRENSBURG MO
64093-9608
US

IV. Provider business mailing address

638 E YOUNG AVE
WARRENSBURG MO
64093-9608
US

V. Phone/Fax

Practice location:
  • Phone: 660-429-5533
  • Fax: 660-429-5554
Mailing address:
  • Phone: 660-429-5533
  • Fax: 660-429-5554

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2002024548
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: