Healthcare Provider Details

I. General information

NPI: 1891733556
Provider Name (Legal Business Name): WESTERN MISSOURI BONE AND JOINT, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

510 FOSTER LN SUITE 101
WARRENSBURG MO
64093-3213
US

IV. Provider business mailing address

510 FOSTER LN SUITE 101
WARRENSBURG MO
64093-3213
US

V. Phone/Fax

Practice location:
  • Phone: 660-747-2228
  • Fax: 660-747-7677
Mailing address:
  • Phone: 660-747-2228
  • Fax: 660-747-7677

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. GREG ALLAN BLISS
Title or Position: ADMINISTRATOR
Credential: M.D.
Phone: 660-747-2228