MEDICARE: DR. EMILY B HURT 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	2014001827	MO

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MA5132001	OTHER	MO	MEDICARE PTAN

General Provider Information

NPI Number	:	1023423142
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EMILY B HURT D.C.

Provider Business Mailing Address
First Line	:	4122 NE VIVION RD
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64119-2811
Country	:	US
Telephone Number	:	816-453-3331
Fax Number	:

Provider Business Practice Location Address
First Line	:	4122 NE VIVION RD
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64119-2811
Country	:	US
Telephone Number	:	816-453-3331
Fax Number	:

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

Provider Enumeration Date	:	06/26/2014
Last Update Date	:	12/01/2015

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