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General NPI Number Information
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NPI Number | 1760620421
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Entity Type | Individual
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Provider Name | GARY LEE PAYNE DC
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Gender | Male
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Dates
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Enumeration Date | 02/03/2009
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Last Update Date | 03/16/2010
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Provider Practice Location Address
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Address Line | 4301 MAIN ST SUITE 6
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City | KANSAS CITY
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State | MO
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Zip | 64111-7701
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Country | US
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Telephone | 816-877-4124
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Fax |
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Provider Business Mailing Address
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Address Line | 4142 MCGEE ST
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City | KANSAS CITY
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State | MO
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Zip | 64111-1609
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Country | US
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Telephone | 816-931-3506
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 2008035499
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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 | 01-05236
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License Number State | KS
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