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NPI Code Detail

MEDICARE: CAVNESS CHIRO INC.

MEDICARE: CAVNESS CHIRO INC.
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
1111N00000XChiropractor2004003313MO

General Provider Information

NPI Number : 1194981183
Entity Type Code : Organization
Provider Name (Legal Business Name) : CAVNESS CHIRO INC.
Provider Business Mailing Address
First Line : 1226 INDEPENDENCE AVE
Second Line :
City : KENNETT
State : MO
Zip : 63857-1316
Country : US
Telephone Number : 573-888-9990
Fax Number : 573-888-9993
Provider Business Practice Location Address
First Line : 1226 INDEPENDENCE AVE
Second Line :
City : KENNETT
State : MO
Zip : 63857-1316
Country : US
Telephone Number : 573-888-9990
Fax Number : 573-888-9993
Authorized Official
Title or Position : OWNER
Name : DR. BRADLEY SCOTT CAVNESS
Credential : D.C.
Telephone Number : 573-888-9990
Provider Enumeration Date : 07/30/2008
Last Update Date : 07/30/2008

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Directions to “CAVNESS CHIRO INC. ” Practice Location

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