Provider Demographics
NPI:1942482757
Name:JOSEPH SYMES CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:JOSEPH SYMES CHIROPRACTIC LLC
Other - Org Name:REJUVENATE MIND-BODY WELLNESS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOE
Authorized Official - Middle Name:
Authorized Official - Last Name:SYMES
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:816-761-3944
Mailing Address - Street 1:400 SW LONGVIEW BLVD
Mailing Address - Street 2:SUITE 160
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64081-2102
Mailing Address - Country:US
Mailing Address - Phone:816-761-3944
Mailing Address - Fax:
Practice Address - Street 1:400 SW LONGVIEW BLVD
Practice Address - Street 2:SUITE 160
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64081-2102
Practice Address - Country:US
Practice Address - Phone:816-761-3944
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-04
Last Update Date:2014-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2007016856111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOP37357025OtherBLUE CROSS BLUE SHIELD OF KANSAS CITY
MOP37357025OtherBLUE CROSS BLUE SHIELD OF KANSAS CITY