Provider Demographics
NPI:1992525547
Name:MUMMA, BRHETT (DC)
Entity type:Individual
Prefix:
First Name:BRHETT
Middle Name:
Last Name:MUMMA
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 1:9218 SW STATE ROUTE PP
Mailing Address - Street 2:
Mailing Address - City:RICH HILL
Mailing Address - State:MO
Mailing Address - Zip Code:64779-1874
Mailing Address - Country:US
Mailing Address - Phone:660-227-0275
Mailing Address - Fax:
Practice Address - Street 1:1908 W MECHANIC ST
Practice Address - Street 2:
Practice Address - City:HARRISONVILLE
Practice Address - State:MO
Practice Address - Zip Code:64701-1995
Practice Address - Country:US
Practice Address - Phone:816-380-2436
Practice Address - Fax:816-380-2436
Is Sole Proprietor?:No
Enumeration Date:2024-10-16
Last Update Date:2024-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2023016598111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor