Provider Demographics
NPI:1841600285
Name:HART CHIROPRACTIC, LLC
Entity Type:Organization
Organization Name:HART CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARTIN
Authorized Official - Middle Name:C
Authorized Official - Last Name:HART
Authorized Official - Suffix:V
Authorized Official - Credentials:DC
Authorized Official - Phone:314-229-4793
Mailing Address - Street 1:12500 E US HIGHWAY 40
Mailing Address - Street 2:K
Mailing Address - City:INDEPENDENCE
Mailing Address - State:MO
Mailing Address - Zip Code:64055-5928
Mailing Address - Country:US
Mailing Address - Phone:816-673-5270
Mailing Address - Fax:
Practice Address - Street 1:12500 E US HIGHWAY 40
Practice Address - Street 2:K
Practice Address - City:INDEPENDENCE
Practice Address - State:MO
Practice Address - Zip Code:64055-5928
Practice Address - Country:US
Practice Address - Phone:816-673-5270
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-07
Last Update Date:2014-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2014013451111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty