Provider Demographics
NPI:1093011504
Name:EASLEY CHIROPRACTIC
Entity Type:Organization
Organization Name:EASLEY CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:DILLEN
Authorized Official - Middle Name:P
Authorized Official - Last Name:EASLEY
Authorized Official - Suffix:
Authorized Official - Credentials:BS, DC
Authorized Official - Phone:816-841-2600
Mailing Address - Street 1:5563 NW BARRY RD
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64154-1408
Mailing Address - Country:US
Mailing Address - Phone:816-841-2600
Mailing Address - Fax:816-841-2601
Practice Address - Street 1:5563 NW BARRY RD
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64154-1408
Practice Address - Country:US
Practice Address - Phone:816-841-2600
Practice Address - Fax:816-841-2601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-31
Last Update Date:2011-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2011001827111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty