Provider Demographics
NPI:1497285662
Name:ONE LIFE CHIROPRACTIC PC
Entity Type:Organization
Organization Name:ONE LIFE CHIROPRACTIC PC
Other - Org Name:MY CHIROPRACTOR KC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:JENNINGS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:816-656-1535
Mailing Address - Street 1:900 W 17TH ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64108-1108
Mailing Address - Country:US
Mailing Address - Phone:816-656-1535
Mailing Address - Fax:855-276-2178
Practice Address - Street 1:900 W 17TH ST
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64108-1108
Practice Address - Country:US
Practice Address - Phone:816-656-1535
Practice Address - Fax:855-276-2178
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-19
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2016022435111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty