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General NPI Number Information
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NPI Number | 1992327613
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Entity Type | Organization
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Legal Business Name | QUANTUM WELLNESS LLC
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Dates
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Enumeration Date | 05/15/2020
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Last Update Date | 04/19/2022
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Provider Practice Location Address
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Address Line | 5728 N BROADWAY ST STE D
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City | KANSAS CITY
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State | MO
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Zip | 64118-3997
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Country | US
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Telephone | 816-584-4670
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Fax | 816-708-0804
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Provider Business Mailing Address
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Address Line | 5728 N BROADWAY ST STE D
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City | KANSAS CITY
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State | MO
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Zip | 64118-3997
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Country | US
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Telephone | 816-584-4670
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Fax | 816-708-0804
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Authorized Official
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Title or Position | OWNER
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Name | DR. KRISTINE BAKER
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Credential | DC
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Telephone | 815-584-4670
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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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