Provider Demographics
NPI:1104213883
Name:C AND N VENTURES
Entity Type:Organization
Organization Name:C AND N VENTURES
Other - Org Name:POULIOT CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:NALISA
Authorized Official - Middle Name:L
Authorized Official - Last Name:POULIOT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:816-453-3331
Mailing Address - Street 1:4321 NE VIVION RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64119-2809
Mailing Address - Country:US
Mailing Address - Phone:816-453-3331
Mailing Address - Fax:816-453-3331
Practice Address - Street 1:4321 NE VIVION RD
Practice Address - Street 2:SUITE 102
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64119-2809
Practice Address - Country:US
Practice Address - Phone:816-453-3331
Practice Address - Fax:816-453-3331
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-21
Last Update Date:2015-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO0006425111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO0009863Medicare UPIN