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General NPI Number Information
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NPI Number | 1396105458
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Entity Type | Organization
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Legal Business Name | ELEVATE LIFE CHIROPRACTIC AND WELLNESS LLC
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Dates
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Enumeration Date | 03/02/2016
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Last Update Date | 03/02/2016
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Provider Practice Location Address
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Address Line | 9237 N OAK TRFY
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City | KANSAS CITY
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State | MO
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Zip | 64155-3392
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Country | US
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Telephone | 816-321-1620
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Fax | 816-321-1566
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Provider Business Mailing Address
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Address Line | 9237 N OAK TRFY
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City | KANSAS CITY
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State | MO
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Zip | 64155-3392
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Country | US
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Telephone | 816-321-1620
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Fax | 816-321-1566
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Authorized Official
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Title or Position | OWNER/CHIROPRACTOR
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Name | PAUL HOYAL
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Credential | D.C.
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Telephone | 816-321-1620
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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 | 2015040833
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License Number State | MO
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