Provider Demographics
NPI:1255582581
Name:BECKLEY, DAVID CLARK (DC)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:CLARK
Last Name:BECKLEY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:751 E 63RD ST
Mailing Address - Street 2:STE. 110
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64110-3385
Mailing Address - Country:US
Mailing Address - Phone:816-501-0280
Mailing Address - Fax:816-822-2807
Practice Address - Street 1:751 E 63RD ST
Practice Address - Street 2:STE. 110
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64110-3385
Practice Address - Country:US
Practice Address - Phone:816-501-0280
Practice Address - Fax:816-822-2807
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-06
Last Update Date:2008-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO03965111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor