Provider Demographics
NPI:1841645686
Name:HEALTH SOURCE KC INC
Entity type:Organization
Organization Name:HEALTH SOURCE KC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINIC DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:M
Authorized Official - Last Name:NADOLSKI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:816-294-2281
Mailing Address - Street 1:5424 JOHNSON DR
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:KS
Mailing Address - Zip Code:66205-2911
Mailing Address - Country:US
Mailing Address - Phone:816-294-2281
Mailing Address - Fax:
Practice Address - Street 1:5228 JUNIPER DR
Practice Address - Street 2:
Practice Address - City:ROELAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66205-2124
Practice Address - Country:US
Practice Address - Phone:816-294-2281
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-29
Last Update Date:2016-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Multi-Specialty