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General NPI Number Information
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NPI Number | 1689787723
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Entity Type | Organization
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Legal Business Name | RUSTICI AND ASSOCIATES CHIROPRACTIC
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Dates
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Enumeration Date | 08/15/2006
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Last Update Date | 11/13/2007
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Provider Practice Location Address
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Address Line | 17000 E 40 HWY STE 7
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City | INDEPENDENCE
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State | MO
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Zip | 64055-5394
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Country | US
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Telephone | 816-373-6363
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Fax | 816-373-6386
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Provider Business Mailing Address
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Address Line | 17000 E 40 HWY STE 7
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City | INDEPENDENCE
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State | MO
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Zip | 64055-5394
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Country | US
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Telephone | 816-373-6363
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Fax | 816-373-6386
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. CIRO RUSTICI
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Credential | D.C.
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Telephone | 816-373-6363
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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 | 003592
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License Number State | MO
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