Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 2010002022 | MO |
NPI | 1003148933 |
---|---|
Provider Name | Dr. Benjamin Hadley Chambers |
First Address | Lees Summit, MO 64063-1800 |
Second Address | Lees Summit, MO 64063-1800 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/02/2010 |
Last Update Date | 03/02/2010 |