Provider Demographics
NPI:1396116430
Name:NORTH KANSAS CITY CHIROPRACTIC
Entity type:Organization
Organization Name:NORTH KANSAS CITY CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:DRISKELL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:816-453-8130
Mailing Address - Street 1:3721 N OAK TRFY
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64116-2778
Mailing Address - Country:US
Mailing Address - Phone:816-453-8139
Mailing Address - Fax:816-452-2951
Practice Address - Street 1:3721 N OAK TRFY
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64116-2778
Practice Address - Country:US
Practice Address - Phone:816-453-8139
Practice Address - Fax:816-452-2951
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-15
Last Update Date:2015-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2015033274111N00000X
MO005093111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOPTAN0002379Medicare PIN