Provider Demographics
NPI:1215961834
Name:SONSIADEK, JOSH JOSEPH (DC)
Entity type:Individual
Prefix:DR
First Name:JOSH
Middle Name:JOSEPH
Last Name:SONSIADEK
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 1:3800 S ELIZABETH ST
Mailing Address - Street 2:STE F
Mailing Address - City:INDEPENDENCE
Mailing Address - State:MO
Mailing Address - Zip Code:64057-2650
Mailing Address - Country:US
Mailing Address - Phone:816-795-1121
Mailing Address - Fax:816-795-8141
Practice Address - Street 1:3800 S ELIZABETH ST
Practice Address - Street 2:STE F
Practice Address - City:INDEPENDENCE
Practice Address - State:MO
Practice Address - Zip Code:64057-2650
Practice Address - Country:US
Practice Address - Phone:816-795-1121
Practice Address - Fax:816-795-8141
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-10
Last Update Date:2015-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2001016649111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00219590Medicare PIN