Provider Demographics
NPI:1851383541
Name:PAGE, MILES DAVID (DC)
Entity Type:Individual
Prefix:DR
First Name:MILES
Middle Name:DAVID
Last Name:PAGE
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 1:1436 SW EAGLES PARKWAY
Mailing Address - Street 2:
Mailing Address - City:GRAIN VALLEY
Mailing Address - State:MO
Mailing Address - Zip Code:64029-9455
Mailing Address - Country:US
Mailing Address - Phone:816-228-6912
Mailing Address - Fax:816-867-2029
Practice Address - Street 1:1436 W AA HWY
Practice Address - Street 2:
Practice Address - City:GRAIN VALLEY
Practice Address - State:MO
Practice Address - Zip Code:64029-9455
Practice Address - Country:US
Practice Address - Phone:816-867-2026
Practice Address - Fax:816-867-2029
Is Sole Proprietor?:No
Enumeration Date:2005-08-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO1999137888111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO29565035OtherBCBS
MOQ12A269Medicare ID - Type Unspecified