Provider Demographics
NPI:1386786762
Name:DR. RICARDO LERMA D.C, P.C.
Entity type:Organization
Organization Name:DR. RICARDO LERMA D.C, P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:RICARDO
Authorized Official - Middle Name:
Authorized Official - Last Name:LERMA
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:816-353-7577
Mailing Address - Street 1:2066 SW RACHEL LN
Mailing Address - Street 2:
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64082-4065
Mailing Address - Country:US
Mailing Address - Phone:816-525-0941
Mailing Address - Fax:816-353-7578
Practice Address - Street 1:6600 E 87TH ST
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64138-2733
Practice Address - Country:US
Practice Address - Phone:816-353-7577
Practice Address - Fax:816-353-7578
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2003004143111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO32410018OtherBCBS PROVIDER NUMBER
MO7589489OtherAETNA PROVIDER #
MO7589489OtherAETNA PROVIDER #