Provider Demographics
NPI:1427114503
Name:OBERLE, THERESA MARIE (DC)
Entity type:Individual
Prefix:DR
First Name:THERESA
Middle Name:MARIE
Last Name:OBERLE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7424 CAMPBELL ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64131-1641
Mailing Address - Country:US
Mailing Address - Phone:816-361-5584
Mailing Address - Fax:
Practice Address - Street 1:8080 WARD PKWY
Practice Address - Street 2:SUITE 155
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64114-2034
Practice Address - Country:US
Practice Address - Phone:816-363-5253
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO005661111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO0004616Medicare ID - Type Unspecified
MO15342017Medicare UPIN