Provider Demographics
NPI:1033561030
Name:KANSAS CITY DISC AND NERVE CENTER
Entity Type:Organization
Organization Name:KANSAS CITY DISC AND NERVE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PATIENT ACC. REP
Authorized Official - Prefix:
Authorized Official - First Name:VICKI
Authorized Official - Middle Name:
Authorized Official - Last Name:SHIELDS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-945-8298
Mailing Address - Street 1:350 SW GREENWICH DR.
Mailing Address - Street 2:
Mailing Address - City:LEE'S SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64082
Mailing Address - Country:US
Mailing Address - Phone:816-537-5995
Mailing Address - Fax:816-945-7179
Practice Address - Street 1:350 SW GREENWICH DR.
Practice Address - Street 2:
Practice Address - City:LEE'S SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64082
Practice Address - Country:US
Practice Address - Phone:816-537-5995
Practice Address - Fax:816-945-7179
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-01
Last Update Date:2016-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty