MEDICARE: DR. NORMAN EUGENE BLISS 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
1	111N00000X	Chiropractor	CE4137	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	09741021	OTHER	MO	BCBS KC

General Provider Information

NPI Number	:	1164415253
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NORMAN EUGENE BLISS DC

Provider Business Mailing Address
First Line	:	1300 N US HIGHWAY 65
Second Line	:
City	:	CARROLLTON
State	:	MO
Zip	:	64633-1975
Country	:	US
Telephone Number	:	660-542-2441
Fax Number	:

Provider Business Practice Location Address
First Line	:	1300 N US HIGHWAY 65
Second Line	:
City	:	CARROLLTON
State	:	MO
Zip	:	64633-1975
Country	:	US
Telephone Number	:	660-542-2441
Fax Number	:

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

Provider Enumeration Date	:	08/24/2005
Last Update Date	:	07/08/2007

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