Provider Demographics
NPI:1881858520
Name:THERESA FEBBO DC CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:THERESA FEBBO DC CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF CHIROPRACTIC
Authorized Official - Prefix:MS
Authorized Official - First Name:THERESA
Authorized Official - Middle Name:A
Authorized Official - Last Name:FEBBO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:816-741-8663
Mailing Address - Street 1:6908 NW BARRY RD
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64153-1764
Mailing Address - Country:US
Mailing Address - Phone:816-741-8663
Mailing Address - Fax:816-584-0149
Practice Address - Street 1:6908 NW BARRY RD
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64153-1764
Practice Address - Country:US
Practice Address - Phone:816-741-8663
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-11
Last Update Date:2008-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO005847111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO0002689AMedicare PIN