MEDICARE: DR. JAVID NOOROLLAH 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	01-04907	KS

General Provider Information

NPI Number	:	1891760732
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAVID NOOROLLAH D.C.

Provider Business Mailing Address
First Line	:	9617 BENSON ST
Second Line	:
City	:	OVERLAND PARK
State	:	KS
Zip	:	66212-4033
Country	:	US
Telephone Number	:	913-642-3397
Fax Number	:

Provider Business Practice Location Address
First Line	:	6700 W 121ST ST
Second Line	:	SUITE #200
City	:	OVERLAND PARK
State	:	KS
Zip	:	66209-2027
Country	:	US
Telephone Number	:	913-491-1500
Fax Number	:

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

Provider Enumeration Date	:	02/22/2006
Last Update Date	:	07/08/2007

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