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General NPI Number Information
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NPI Number | 1205845112
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Entity Type | Individual
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Provider Name | RICHARD A PRATHER DC
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Gender | Male
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Dates
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Enumeration Date | 08/07/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 410C SE 3RD ST SUITE 102
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City | LEES SUMMIT
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State | MO
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Zip | 64063-2809
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Country | US
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Telephone | 816-347-1793
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Fax | 816-347-1796
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Provider Business Mailing Address
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Address Line | 410C SE 3RD ST SUITE 102
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City | LEES SUMMIT
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State | MO
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Zip | 64063-2809
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Country | US
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Telephone | 816-347-1793
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Fax | 816-347-1796
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 2005021117
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License Number State | MO
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