Provider Demographics
NPI:1770853012
Name:MASTERSON, ERIN (DC)
Entity Type:Individual
Prefix:DR
First Name:ERIN
Middle Name:
Last Name:MASTERSON
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 1:401 E 92ND TER
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64131-2950
Mailing Address - Country:US
Mailing Address - Phone:913-980-7418
Mailing Address - Fax:
Practice Address - Street 1:401 E 92ND TER
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64131-2950
Practice Address - Country:US
Practice Address - Phone:913-980-7418
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-04
Last Update Date:2012-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2011007953111N00000X
KS01-05422111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor