Healthcare Provider Details

I. General information

NPI: 1336438480
Provider Name (Legal Business Name): FORBES CHIROPRACTIC, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/29/2011
Last Update Date: 03/29/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7504 NW KERNS DR
WEATHERBY LAKE MO
64152-1745
US

IV. Provider business mailing address

7504 NW KERNS DR
WEATHERBY LAKE MO
64152-1745
US

V. Phone/Fax

Practice location:
  • Phone: 816-255-3042
  • Fax: 816-222-0886
Mailing address:
  • Phone: 816-255-3042
  • Fax: 816-222-0886

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2000148380
License Number StateMO

VIII. Authorized Official

Name: JENNIFER LAVONNE FORBES
Title or Position: CHIROPRACTOR/PRESIDENT
Credential: D.C
Phone: 816-255-3042