Shoal Creek Chiropractic Pc | |
11105 N Booth Ave, Kansas City, MO 64157-9205 | |
(660) 322-0641 | |
Not Available |
Full Name | Shoal Creek Chiropractic Pc |
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Type | Facility |
Speciality | Chiropractor |
Location | 11105 N Booth Ave, Kansas City, Missouri |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1508992728 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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111N00000X | Chiropractor | 2005026319 (Missouri) | Primary |
Provider Name | Sean M Dunivent |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1619026275 PECOS PAC ID: 5193745446 Enrollment ID: I20051201000088 |
Provider Name | Bryna M Miller |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1366731408 PECOS PAC ID: 1153508817 Enrollment ID: I20110606000387 |
Mailing Address | Practice Location Address |
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Shoal Creek Chiropractic Pc 11105 N Booth Ave, Kansas City, MO 64157-9205 Ph: (660) 322-0641 | Shoal Creek Chiropractic Pc 11105 N Booth Ave, Kansas City, MO 64157-9205 Ph: (660) 322-0641 |
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