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General NPI Number Information
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NPI Number | 1376744474
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Entity Type | Organization
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Legal Business Name | DR YENNIE CHIROPRACTIC CLINIC INC
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Dates
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Enumeration Date | 05/29/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4140 BROADWAY ST
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City | KANSAS CITY
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State | MO
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Zip | 64111-2617
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Country | US
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Telephone | 816-931-0287
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Fax | 816-931-2127
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Provider Business Mailing Address
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Address Line | 4140 BROADWAY AVE
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City | KANSAS CITY
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State | MO
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Zip | 64111
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Country | US
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Telephone | 816-931-0287
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Fax | 816-931-2127
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RICHARD D YENNIE
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Credential | DC, DIPL AC (NCCAOM)
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Telephone | 816-931-0287
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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 | 002489
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License Number State | MO
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