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General NPI Number Information
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NPI Number | 1770248320
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Entity Type | Organization
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Legal Business Name | CHIRO ONE WELLNESS CENTER OF LIBERTY LLC
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Dates
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Enumeration Date | 11/08/2021
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Last Update Date | 03/20/2023
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Provider Practice Location Address
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Address Line | 9040 NE BARRY RD
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City | KANSAS CITY
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State | MO
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Zip | 64157-1246
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Country | US
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Telephone | 816-368-8700
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 74008519 CHIRO ONE1651
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City | CHICAGO
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State | IL
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Zip | 60674-0001
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Country | US
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Telephone | 630-320-6400
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Fax | 630-468-1478
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Authorized Official
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Title or Position | CEO
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Name | STUART BERNSEN
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Credential |
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Telephone | 630-320-6400
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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 |
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License Number State |
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