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General NPI Number Information
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NPI Number | 1578990214
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Entity Type | Organization
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Legal Business Name | SAGE YOGA AND CHIROPRACTIC LLC
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Dates
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Enumeration Date | 09/26/2013
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Last Update Date | 06/24/2014
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Provider Practice Location Address
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Address Line | 1907 WYANDOTTE ST
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City | KANSAS CITY
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State | MO
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Zip | 64108-1903
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Country | US
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Telephone | 816-283-3108
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Fax | 877-210-2904
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Provider Business Mailing Address
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Address Line | 1907 WYANDOTTE ST
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City | KANSAS CITY
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State | MO
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Zip | 64108-1903
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Country | US
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Telephone | 816-283-3108
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Fax | 877-210-2904
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Authorized Official
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Title or Position | OWNER
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Name | MS. SARAH BETH KUCERA
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Credential | D.C.
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Telephone | 816-283-3108
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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 | 20120112234
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 2007012106
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License Number State | MO
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