Provider Demographics
NPI:1518292549
Name:PEERY, SIMON RAY (DC)
Entity Type:Individual
Prefix:
First Name:SIMON
Middle Name:RAY
Last Name:PEERY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:811 E LINWOOD BLVD
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64109-1723
Mailing Address - Country:US
Mailing Address - Phone:816-756-2500
Mailing Address - Fax:816-531-5280
Practice Address - Street 1:811 E LINWOOD BLVD
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64109-1723
Practice Address - Country:US
Practice Address - Phone:816-756-2500
Practice Address - Fax:816-531-5280
Is Sole Proprietor?:No
Enumeration Date:2009-10-08
Last Update Date:2015-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-05254111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor