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General NPI Number Information
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NPI Number | 1528312659
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Entity Type | Organization
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Legal Business Name | LEES SUMMIT FAMILY CHIROPRACTIC PC
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Dates
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Enumeration Date | 10/26/2012
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Last Update Date | 04/22/2016
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Provider Practice Location Address
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Address Line | 618 SW 3RD ST UNIT H
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City | LEES SUMMIT
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State | MO
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Zip | 64063-2277
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Country | US
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Telephone | 816-694-7623
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Fax |
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Provider Business Mailing Address
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Address Line | 618 SW 3RD ST UNIT H
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City | LEES SUMMIT
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State | MO
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Zip | 64063-2277
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Country | US
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Telephone | 816-694-7623
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Fax |
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Authorized Official
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Title or Position | HEAD DOCTOR
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Name | DR. ERICA SIMPSON
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Credential | D.C.
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Telephone | 816-694-7623
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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 | 2011041270
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License Number State | MO
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