Provider Demographics
NPI:1407398365
Name:LAKEWOOD CHIROPRACTIC, P.C.
Entity Type:Organization
Organization Name:LAKEWOOD CHIROPRACTIC, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SARA
Authorized Official - Middle Name:
Authorized Official - Last Name:HORN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:816-373-3373
Mailing Address - Street 1:731 NE LAKEWOOD BLVD
Mailing Address - Street 2:
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64064-1353
Mailing Address - Country:US
Mailing Address - Phone:816-373-3373
Mailing Address - Fax:816-373-2902
Practice Address - Street 1:731 NE LAKEWOOD BOULEVARD
Practice Address - Street 2:
Practice Address - City:LEE'S SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64064
Practice Address - Country:US
Practice Address - Phone:816-373-3373
Practice Address - Fax:816-373-2902
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-09
Last Update Date:2023-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2016032484111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
No111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty