MEDICARE: GAKDC LLC

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

General Provider Information

NPI Number	:	1982124830
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GAKDC LLC

Provider Business Mailing Address
First Line	:	10504 E 59TH ST
Second Line	:
City	:	RAYTOWN
State	:	MO
Zip	:	64133-3428
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6716 N OAK TRFY
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64118-3345
Country	:	US
Telephone Number	:	815-436-7153
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	GREG KRAM
Credential	:	DC
Telephone Number	:	816-916-7621

Provider Enumeration Date	:	06/21/2017
Last Update Date	:	06/16/2018

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Directions to “GAKDC LLC ” Practice Location

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