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General NPI Number Information
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NPI Number | 1841600285
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Entity Type | Organization
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Legal Business Name | HART CHIROPRACTIC, LLC
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Dates
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Enumeration Date | 05/07/2014
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Last Update Date | 05/15/2014
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Provider Practice Location Address
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Address Line | 12500 E US HIGHWAY 40 K
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City | INDEPENDENCE
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State | MO
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Zip | 64055-5928
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Country | US
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Telephone | 816-673-5270
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Fax |
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Provider Business Mailing Address
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Address Line | 12500 E US HIGHWAY 40 K
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City | INDEPENDENCE
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State | MO
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Zip | 64055-5928
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Country | US
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Telephone | 816-673-5270
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. MARTIN C HART V
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Credential | D.C.
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Telephone | 314-229-4793
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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 | 2014013451
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License Number State | MO
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