=====================================================
General NPI Number Information
=====================================================
NPI Number | 1902029283
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CROWE FAMILY CHIROPRACTIC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/11/2007
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4301 MAIN ST SUITE 7
-----------------------------------------------------
City | KANSAS CITY
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 64111-7701
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 816-931-4646
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4301 MAIN ST SUITE 7
-----------------------------------------------------
City | KANSAS CITY
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 64111-7701
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 816-931-4646
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. AMY M. CROWE
-----------------------------------------------------
Credential | D.C.
-----------------------------------------------------
Telephone | 816-931-4646
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | 2006002500
-----------------------------------------------------
License Number State | MO
-----------------------------------------------------