Provider Demographics
NPI:1114347218
Name:TRUE VITALITY CHIROPRACTIC, LLC
Entity Type:Organization
Organization Name:TRUE VITALITY CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JULIAN
Authorized Official - Middle Name:R
Authorized Official - Last Name:GILES
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:816-499-0037
Mailing Address - Street 1:8560 N GREEN HILLS RD
Mailing Address - Street 2:SUITE 118
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64154-1403
Mailing Address - Country:US
Mailing Address - Phone:816-584-0520
Mailing Address - Fax:816-584-0495
Practice Address - Street 1:8560 N GREEN HILLS RD
Practice Address - Street 2:SUITE 118
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64154-1403
Practice Address - Country:US
Practice Address - Phone:816-584-0520
Practice Address - Fax:816-584-0495
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-16
Last Update Date:2015-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2014001130111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty