MEDICARE: STABILITY WISDOM

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	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1417479114
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STABILITY WISDOM

Provider Business Mailing Address
First Line	:	14634 S ACUFF LN
Second Line	:
City	:	OLATHE
State	:	KS
Zip	:	66062-6565
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	935 S 55TH ST
Second Line	:
City	:	KANSAS CITY
State	:	KS
Zip	:	66106-1309
Country	:	US
Telephone Number	:	913-287-5210
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. BETH D'ANNA
Credential	:	CHIROPRACTIC
Telephone Number	:	630-207-1732

Provider Enumeration Date	:	07/13/2017
Last Update Date	:	07/13/2017

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Directions to “STABILITY WISDOM ” Practice Location

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