Provider Demographics
NPI:1366902975
Name:ESSENTIAL CHIROPRACTIC LLC
Entity type:Organization
Organization Name:ESSENTIAL CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KRISTEN
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:RAS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:708-217-5665
Mailing Address - Street 1:419A SW WARD RD
Mailing Address - Street 2:
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64081-2448
Mailing Address - Country:US
Mailing Address - Phone:816-895-1800
Mailing Address - Fax:816-895-1837
Practice Address - Street 1:419A SW WARD RD
Practice Address - Street 2:
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64081-2448
Practice Address - Country:US
Practice Address - Phone:816-895-1800
Practice Address - Fax:816-895-1837
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-20
Last Update Date:2019-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center