Provider Demographics
NPI:1679849665
Name:CHIRA CHIROPRACTIC AND WELLNESS CEN
Entity Type:Organization
Organization Name:CHIRA CHIROPRACTIC AND WELLNESS CEN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF CHIROPRACTIC
Authorized Official - Prefix:DR
Authorized Official - First Name:UCHENNA
Authorized Official - Middle Name:C
Authorized Official - Last Name:CHIRA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:816-886-7261
Mailing Address - Street 1:6124 BLUE RIDGE BLVD
Mailing Address - Street 2:
Mailing Address - City:RAYTOWN
Mailing Address - State:MO
Mailing Address - Zip Code:64133-4148
Mailing Address - Country:US
Mailing Address - Phone:816-886-7261
Mailing Address - Fax:816-886-7263
Practice Address - Street 1:6124 BLUE RIDGE BLVD
Practice Address - Street 2:
Practice Address - City:RAYTOWN
Practice Address - State:MO
Practice Address - Zip Code:64133-4148
Practice Address - Country:US
Practice Address - Phone:816-886-7261
Practice Address - Fax:816-886-7263
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-24
Last Update Date:2012-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2011038410302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization