Provider Demographics
NPI:1932625027
Name:HEALING WELL CHIROPRACTIC LEE'S SUMMIT LLC
Entity Type:Organization
Organization Name:HEALING WELL CHIROPRACTIC LEE'S SUMMIT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:KRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:STROUF
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:816-795-0300
Mailing Address - Street 1:19101 E VALLEY VIEW PKWY STE J
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:MO
Mailing Address - Zip Code:64055-6907
Mailing Address - Country:US
Mailing Address - Phone:816-795-0300
Mailing Address - Fax:
Practice Address - Street 1:19101 E VALLEY VIEW PKWY STE J
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:MO
Practice Address - Zip Code:64055-6907
Practice Address - Country:US
Practice Address - Phone:816-795-0300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2005022241111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty