Provider Demographics
NPI:1881750990
Name:OPPENHEIMER, LLC, BARRY (DC)
Entity type:Individual
Prefix:
First Name:BARRY
Middle Name:
Last Name:OPPENHEIMER, LLC
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 1:1802 SWIFT AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64116-3607
Mailing Address - Country:US
Mailing Address - Phone:816-471-3600
Mailing Address - Fax:816-471-3609
Practice Address - Street 1:1802 SWIFT
Practice Address - Street 2:
Practice Address - City:NORTH KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64116-3512
Practice Address - Country:US
Practice Address - Phone:816-471-3600
Practice Address - Fax:816-471-3609
Is Sole Proprietor?:No
Enumeration Date:2007-01-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO006304111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOU53587Medicare ID - Type Unspecified