MEDICARE: ANNE-LAURE GAUTHIER 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	5696	MO

General Provider Information

NPI Number	:	1700859675
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANNE-LAURE GAUTHIER D.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	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/09/2006
Last Update Date	:	07/08/2007

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