Provider Demographics
NPI:1891965984
Name:ANSCHUTZ, SUSAN M (DC)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:M
Last Name:ANSCHUTZ
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19501 E US HIGHWAY 40 STE B
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:MO
Mailing Address - Zip Code:64055-5475
Mailing Address - Country:US
Mailing Address - Phone:816-795-5000
Mailing Address - Fax:816-795-5001
Practice Address - Street 1:19501 E US HIGHWAY 40 STE B
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:MO
Practice Address - Zip Code:64055-5475
Practice Address - Country:US
Practice Address - Phone:816-795-5000
Practice Address - Fax:816-795-5001
Is Sole Proprietor?:No
Enumeration Date:2008-03-05
Last Update Date:2016-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2008002552111N00000X, 111NN1001X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NN1001XChiropractic ProvidersChiropractorNutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO11950405OtherCAQH
MO1013037597OtherBATEMAN-GATROST, PC GROUP NPI
MO11950405OtherCAQH