Provider Demographics
NPI:1740488089
Name:GATES CHIROPRACTIC
Entity type:Organization
Organization Name:GATES CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JACQUELYN
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:GATES
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:816-554-6926
Mailing Address - Street 1:229 NW BLUE PKWY
Mailing Address - Street 2:SUITE C
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64063-1869
Mailing Address - Country:US
Mailing Address - Phone:816-554-6926
Mailing Address - Fax:816-554-6927
Practice Address - Street 1:229 NW BLUE PKWY
Practice Address - Street 2:SUITE C
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64063-1869
Practice Address - Country:US
Practice Address - Phone:816-554-6926
Practice Address - Fax:816-554-6927
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-09
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO004087111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty