Provider Demographics
NPI:1184928806
Name:HILDEBRAND CHIROPRACTIC AND REHAB L.L.C
Entity type:Organization
Organization Name:HILDEBRAND CHIROPRACTIC AND REHAB L.L.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JUSTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:HILDEBRAND
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:816-584-0413
Mailing Address - Street 1:8303 N CONGRESS AVE.
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64152
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8303 N CONGRESS AVE
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64152
Practice Address - Country:US
Practice Address - Phone:816-261-7928
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-10
Last Update Date:2015-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2011000585111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty