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7210 Wornall Rd, Kansas City, MO 64114-1345 | |
(816) 333-2533 | |
(816) 333-2586 |
Full Name | |
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Type | Facility |
Speciality | Family Medicine |
Location | 7210 Wornall Rd, 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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1972761187 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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111N00000X | Chiropractor | 2007030924 (Missouri) | Secondary |
207Q00000X | Family Medicine | 33655 (Missouri) | Primary |
225100000X | Physical Therapist | 20110310891 (Missouri) | Secondary |
Provider Name | Leslie K Wiscombe |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1235123126 PECOS PAC ID: 5193764306 Enrollment ID: I20050427000872 |
Provider Name | Randy L Kellerman |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1790973881 PECOS PAC ID: 2264502269 Enrollment ID: I20080603000340 |
Provider Name | David A Dover |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1598907560 PECOS PAC ID: 4688798291 Enrollment ID: I20100903000409 |
Mailing Address | Practice Location Address |
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7210 Wornall Rd, Kansas City, MO 64114-1345 Ph: (816) 333-2533 | 7210 Wornall Rd, Kansas City, MO 64114-1345 Ph: (816) 333-2533 |