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NPI Code Detail

MEDICARE: DR. JOSHUA MIDDENDORF D.C.

MEDICARE:  DR. JOSHUA  MIDDENDORF  D.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111N00000XChiropractor2011001547MO

General Provider Information

NPI Number : 1003111956
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOSHUA MIDDENDORF D.C.
Provider Business Mailing Address
First Line : 1512 S 27TH ST
Second Line :
City : SAINT JOSEPH
State : MO
Zip : 64507-1847
Country : US
Telephone Number : 816-232-9437
Fax Number :
Provider Business Practice Location Address
First Line : 1512 S 27TH ST
Second Line :
City : SAINT JOSEPH
State : MO
Zip : 64507-1847
Country : US
Telephone Number : 816-232-9437
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/24/2011
Last Update Date : 01/24/2011

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Directions to “ DR. JOSHUA MIDDENDORF D.C.” Practice Location

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