Provider Demographics
NPI:1689325102
Name:BESAND, CAITLIN JEAN (DC)
Entity Type:Individual
Prefix:
First Name:CAITLIN
Middle Name:JEAN
Last Name:BESAND
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:CAITLIN
Other - Middle Name:JEAN
Other - Last Name:WORSHAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:1231 THOUVENOT LN
Mailing Address - Street 2:
Mailing Address - City:SHILOH
Mailing Address - State:IL
Mailing Address - Zip Code:62269-7203
Mailing Address - Country:US
Mailing Address - Phone:816-234-8300
Mailing Address - Fax:
Practice Address - Street 1:1231 THOUVENOT LN
Practice Address - Street 2:
Practice Address - City:SHILOH
Practice Address - State:IL
Practice Address - Zip Code:62269-7203
Practice Address - Country:US
Practice Address - Phone:618-234-8300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-17
Last Update Date:2022-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2021050934111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOW133319003OtherLICENSE