Provider Demographics
NPI:1477875961
Name:CARTWRIGHT, MICHAEL RYAN (DC)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:RYAN
Last Name:CARTWRIGHT
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 1:413 PACIFIC DR
Mailing Address - Street 2:
Mailing Address - City:BELTON
Mailing Address - State:MO
Mailing Address - Zip Code:64012-2993
Mailing Address - Country:US
Mailing Address - Phone:816-258-0422
Mailing Address - Fax:816-817-2166
Practice Address - Street 1:319 MAIN ST
Practice Address - Street 2:
Practice Address - City:BELTON
Practice Address - State:MO
Practice Address - Zip Code:64012-2509
Practice Address - Country:US
Practice Address - Phone:816-258-0422
Practice Address - Fax:816-817-2166
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-24
Last Update Date:2017-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2010001448111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOMA6371Medicare PIN