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General NPI Number Information
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NPI Number | 1093254633
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Entity Type | Organization
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Legal Business Name | KANSAS CITY SPINE AND WELLNESS CLINIC, LLC
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Dates
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Enumeration Date | 02/15/2017
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Last Update Date | 01/20/2023
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Provider Practice Location Address
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Address Line | 1010 CARONDELET DR SUITE 204
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City | KANSAS CITY
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State | MO
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Zip | 64114-4859
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Country | US
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Telephone | 816-384-2300
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Fax | 816-384-2301
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Provider Business Mailing Address
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Address Line | 1010 CARONDELET DR SUITE 204
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City | KANSAS CITY
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State | MO
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Zip | 64114-4859
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Country | US
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Telephone | 816-384-2300
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Fax | 816-384-2301
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Authorized Official
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Title or Position | OWNER
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Name | DR. YARA JOUHARI
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Credential | DC
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Telephone | 816-384-2300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 2010018713
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License Number State | MO
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