Provider Demographics
NPI:1194298836
Name:DYNAMIC HEALTHCARE PARTNERS LLC
Entity type:Organization
Organization Name:DYNAMIC HEALTHCARE PARTNERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:PHILLIPS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-668-4689
Mailing Address - Street 1:20509 E BLUE MILLS RD
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:MO
Mailing Address - Zip Code:64058-2054
Mailing Address - Country:US
Mailing Address - Phone:816-668-4689
Mailing Address - Fax:
Practice Address - Street 1:20509 E BLUE MILLS RD
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:MO
Practice Address - Zip Code:64058-2054
Practice Address - Country:US
Practice Address - Phone:816-668-4689
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-04
Last Update Date:2019-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty