MEDICARE: GAUTHIER CHIROPRACTIC CLINIC, P. 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	5696	MO

General Provider Information

NPI Number	:	1679610299
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GAUTHIER CHIROPRACTIC CLINIC, P. C.

Provider Business Mailing Address
First Line	:	6008 N STATE ROUTE 9
Second Line	:	SUITE A
City	:	PARKVILLE
State	:	MO
Zip	:	64152-3549
Country	:	US
Telephone Number	:	816-741-9232
Fax Number	:	816-741-3118

Provider Business Practice Location Address
First Line	:	6008 N STATE ROUTE 9
Second Line	:	SUITE A
City	:	PARKVILLE
State	:	MO
Zip	:	64152-3549
Country	:	US
Telephone Number	:	816-741-9232
Fax Number	:	816-741-3118

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	DR. ANNE-LAURE GAUTHIER
Credential	:	D.C.
Telephone Number	:	816-741-9232

Provider Enumeration Date	:	01/31/2007
Last Update Date	:	08/22/2020

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