MEDICARE: KEARNEY FAMILY CHIROPRACTIC CENTER PC

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	006596	MO

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00136493	OTHER	MO	RAILROAD MEDICARE INDIV #
4	DB9153	OTHER	MO	RAILROAD MEDICARE GRP #

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	36485011	OTHER	MO	BC/BS GRP #
3	24559023	OTHER	MO	BC/BS INDV #

General Provider Information

NPI Number	:	1982675823
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KEARNEY FAMILY CHIROPRACTIC CENTER PC

Provider Business Mailing Address
First Line	:	301 S PLATTE CLAY WAY
Second Line	:	SUITE B
City	:	KEARNEY
State	:	MO
Zip	:	64060-8214
Country	:	US
Telephone Number	:	816-628-6738
Fax Number	:	816-628-6739

Provider Business Practice Location Address
First Line	:	301 S PLATTE CLAY WAY
Second Line	:	SUITE B
City	:	KEARNEY
State	:	MO
Zip	:	64060-8214
Country	:	US
Telephone Number	:	816-628-6738
Fax Number	:	816-628-6739

Authorized Official
Title or Position	:	PROVIDER
Name	:	DR. MARK D STRATHMAN
Credential	:	D.C.
Telephone Number	:	816-628-6738

Provider Enumeration Date	:	01/30/2006
Last Update Date	:	04/15/2010

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Directions to “KEARNEY FAMILY CHIROPRACTIC CENTER PC ” Practice Location

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