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General NPI Number Information
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NPI Number | 1477070431
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Entity Type | Organization
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Legal Business Name | KC WELLNESS CENTER, INC
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Dates
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Enumeration Date | 08/29/2017
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Last Update Date | 08/29/2017
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Provider Practice Location Address
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Address Line | 5417 JOHNSON DR
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City | MISSION
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State | KS
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Zip | 66205-2912
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Country | US
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Telephone | 816-841-4865
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Fax | 816-841-4801
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Provider Business Mailing Address
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Address Line | 5812 N AMES AVE
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City | KANSAS CITY
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State | MO
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Zip | 64151-2183
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Country | US
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Telephone | 816-694-1658
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Fax | 816-841-4801
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Authorized Official
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Title or Position | MANAGER
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Name | JOHN BRITTON
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Credential |
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Telephone | 816-694-1658
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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