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General NPI Number Information
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NPI Number | 1326245630
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Entity Type | Organization
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Legal Business Name | PHAMILY CHIROPRACTIC & ACUPUNCTURE
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Dates
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Enumeration Date | 06/29/2007
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Last Update Date | 11/09/2007
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Provider Practice Location Address
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Address Line | 2014 SWIFT AVE
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City | NORTH KANSAS CITY
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State | MO
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Zip | 64116-3424
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Country | US
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Telephone | 816-221-7426
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Fax | 816-221-7426
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Provider Business Mailing Address
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Address Line | 2014 SWIFT AVE
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City | NORTH KANSAS CITY
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State | MO
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Zip | 64116-3424
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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 | CLINIC DOCTOR
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Name | DR. TRUONG PHAM
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Credential | DC
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Telephone | 816-221-7426
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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 | 2004001514
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License Number State | MO
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