MEDICARE: DR GERALD YURTH CHIROPRACTOR LLC

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	2895	MO

General Provider Information

NPI Number	:	1275855660
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR GERALD YURTH CHIROPRACTOR LLC

Provider Business Mailing Address
First Line	:	1512 S 27TH ST
Second Line	:
City	:	SAINT JOSEPH
State	:	MO
Zip	:	64507-1847
Country	:	US
Telephone Number	:	816-232-9437
Fax Number	:	816-232-7434

Provider Business Practice Location Address
First Line	:	1512 S 27TH ST
Second Line	:
City	:	SAINT JOSEPH
State	:	MO
Zip	:	64507-1847
Country	:	US
Telephone Number	:	816-232-9437
Fax Number	:	816-232-7434

Authorized Official
Title or Position	:	SINGLE MEMBER
Name	:	DR. GERALD OLIVER YURTH
Credential	:	D.C.
Telephone Number	:	816-232-9437

Provider Enumeration Date	:	02/25/2010
Last Update Date	:	02/25/2010

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