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NPI Code Detail

MEDICARE: JEFFREY D SPOONEMORE DC

MEDICARE: JEFFREY D SPOONEMORE DC
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
1111N00000XChiropractor0104625KS

General Provider Information

NPI Number : 1053473520
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEFFREY D SPOONEMORE DC
Provider Business Mailing Address
First Line : 2110 E SANTA FE ST
Second Line : FULK CHIROPRACTIC, P.A.
City : OLATHE
State : KS
Zip : 66062-1607
Country : US
Telephone Number : 913-764-6237
Fax Number : 913-397-8230
Provider Business Practice Location Address
First Line : 2110 E SANTA FE ST
Second Line : FULK CHIROPRACTIC, P.A.
City : OLATHE
State : KS
Zip : 66062-1607
Country : US
Telephone Number : 913-764-6237
Fax Number : 913-397-8230
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/14/2006
Last Update Date : 07/20/2010

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Directions to “ JEFFREY D SPOONEMORE DC” Practice Location

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