Provider Demographics
NPI:1982675823
Name:KEARNEY FAMILY CHIROPRACTIC CENTER PC
Entity Type:Organization
Organization Name:KEARNEY FAMILY CHIROPRACTIC CENTER PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:D
Authorized Official - Last Name:STRATHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:816-628-6738
Mailing Address - Street 1:301 S PLATTE CLAY WAY
Mailing Address - Street 2:SUITE B
Mailing Address - City:KEARNEY
Mailing Address - State:MO
Mailing Address - Zip Code:64060-8214
Mailing Address - Country:US
Mailing Address - Phone:816-628-6738
Mailing Address - Fax:816-628-6739
Practice Address - Street 1:301 S PLATTE CLAY WAY
Practice Address - Street 2:SUITE B
Practice Address - City:KEARNEY
Practice Address - State:MO
Practice Address - Zip Code:64060-8214
Practice Address - Country:US
Practice Address - Phone:816-628-6738
Practice Address - Fax:816-628-6739
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-30
Last Update Date:2010-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO006596111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOP00136493OtherRAILROAD MEDICARE INDIV #
MO36485011OtherBC/BS GRP #
MO24559023OtherBC/BS INDV #
MODB9153OtherRAILROAD MEDICARE GRP #
MO24559023OtherBC/BS INDV #
MO36485011OtherBC/BS GRP #
MOP00136493OtherRAILROAD MEDICARE INDIV #