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General NPI Number Information
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NPI Number | 1184439721
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Entity Type | Organization
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Legal Business Name | OPUS TANTI, LLC
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Dates
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Enumeration Date | 02/11/2025
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Last Update Date | 02/11/2025
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Provider Practice Location Address
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Address Line | 3834 S ROGERS CIR
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City | INDEPENDENCE
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State | MO
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Zip | 64055-3601
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Country | US
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Telephone | 816-820-4615
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Fax |
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Provider Business Mailing Address
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Address Line | 3834 S ROGERS CIR
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City | INDEPENDENCE
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State | MO
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Zip | 64055-3601
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIETITIAN/OWNER
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Name | KACEY HENIK
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Credential | RD
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Telephone | 816-820-4615
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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