MEDICARE: JEFFREY DEAN SPENCER 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	006678	MO

General Provider Information

NPI Number	:	1609965169
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEFFREY DEAN SPENCER DC

Provider Business Mailing Address
First Line	:	1414 NW VIVION RD
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64118-4555
Country	:	US
Telephone Number	:	816-746-8300
Fax Number	:	816-746-7958

Provider Business Practice Location Address
First Line	:	1414 NW VIVION RD
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64118-4555
Country	:	US
Telephone Number	:	816-746-8300
Fax Number	:	816-746-7958

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

Provider Enumeration Date	:	10/12/2006
Last Update Date	:	07/08/2007

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Directions to “ JEFFREY DEAN SPENCER DC” Practice Location

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