MEDICARE: DOROTHY ANN EMERY 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
1	111N00000X	Chiropractor	CE005416	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	15130-021	OTHER	MO	BCBS PROVIDER #

General Provider Information

NPI Number	:	1023165719
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DOROTHY ANN EMERY D.C.

Provider Business Mailing Address
First Line	:	6506A NW PRAIRIE VIEW RD
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64151-2303
Country	:	US
Telephone Number	:	816-587-7711
Fax Number	:	816-587-3460

Provider Business Practice Location Address
First Line	:	6506A NW PRAIRIE VIEW RD
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64151-2303
Country	:	US
Telephone Number	:	816-587-7711
Fax Number	:	816-587-3460

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/04/2007
Last Update Date	:	07/08/2007

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