MEDICARE: DR. JASON LEN MEISENHEIMER D.C.

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	006411	MO

General Provider Information

NPI Number	:	1659314334
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JASON LEN MEISENHEIMER D.C.

Provider Business Mailing Address
First Line	:	1229 E AUSTIN BLVD
Second Line	:
City	:	NEVADA
State	:	MO
Zip	:	64772
Country	:	US
Telephone Number	:	417-667-3699
Fax Number	:

Provider Business Practice Location Address
First Line	:	1229 E AUSTIN BLVD
Second Line	:
City	:	NEVADA
State	:	MO
Zip	:	64772
Country	:	US
Telephone Number	:	417-667-3699
Fax Number	:

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

Provider Enumeration Date	:	06/13/2006
Last Update Date	:	04/25/2019

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