Provider Demographics
NPI:1275855660
Name:DR GERALD YURTH CHIROPRACTOR LLC
Entity Type:Organization
Organization Name:DR GERALD YURTH CHIROPRACTOR LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SINGLE MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:GERALD
Authorized Official - Middle Name:OLIVER
Authorized Official - Last Name:YURTH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:816-232-9437
Mailing Address - Street 1:1512 S 27TH ST
Mailing Address - Street 2:
Mailing Address - City:SAINT JOSEPH
Mailing Address - State:MO
Mailing Address - Zip Code:64507-1847
Mailing Address - Country:US
Mailing Address - Phone:816-232-9437
Mailing Address - Fax:816-232-7434
Practice Address - Street 1:1512 S 27TH ST
Practice Address - Street 2:
Practice Address - City:SAINT JOSEPH
Practice Address - State:MO
Practice Address - Zip Code:64507-1847
Practice Address - Country:US
Practice Address - Phone:816-232-9437
Practice Address - Fax:816-232-7434
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-25
Last Update Date:2010-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2895111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO2868Medicare PIN