Provider Demographics
NPI:1205288248
Name:NOBLE CHIROPRACTIC
Entity type:Organization
Organization Name:NOBLE CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:NOBLE-AMERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-635-0022
Mailing Address - Street 1:17411 ENDICOTT RD
Mailing Address - Street 2:
Mailing Address - City:KEARNEY
Mailing Address - State:MO
Mailing Address - Zip Code:64060-9317
Mailing Address - Country:US
Mailing Address - Phone:816-635-0022
Mailing Address - Fax:816-929-6404
Practice Address - Street 1:607 W STATE ROUTE 92 STE CC
Practice Address - Street 2:
Practice Address - City:KEARNEY
Practice Address - State:MO
Practice Address - Zip Code:64060-7521
Practice Address - Country:US
Practice Address - Phone:816-635-0022
Practice Address - Fax:816-929-6404
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-01
Last Update Date:2018-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2012013071111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOW16000005Medicare PIN