| Bridge Integrative Medicine Llc | |
|
305 Nw Englewood Ct Ste 200 Kansas City MO 64118 | |
| (816) 454-5433 | |
| (816) 454-8455 |
| Full Name | Bridge Integrative Medicine Llc |
|---|---|
| Speciality | General Practice |
| Location | 305 Nw Englewood Ct Ste 200, Kansas City, Missouri |
| Authorized Official Name and Position | James A Wyllie (CHIEF OF OPERATIONS) |
| Authorized Official Contact | 8164545433 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bridge Integrative Medicine Llc 305 Nw Englewood Court Suite 200 Kansas City MO 64118-4000 Ph: (816) 454-5433 | Bridge Integrative Medicine Llc 305 Nw Englewood Ct Ste 200 Kansas City MO 64118 Ph: (816) 454-5433 |
| NPI Number | 1740784214 |
|---|---|
| Provider Enumeration Date | 03/20/2018 |
| Last Update Date | 07/23/2018 |
| Medicare PECOS PAC ID | 9638426836 |
|---|---|
| Medicare Enrollment ID | O20180719000120 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740784214 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Christopher M Mcclenney |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1275570780 PECOS PAC ID: 7810962321 Enrollment ID: I20040828000177 |
| Provider Name | James A Wyllie |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1952408924 PECOS PAC ID: 1254436603 Enrollment ID: I20070413000495 |
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