Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 004377 | MO |
NPI | 1013021047 |
---|---|
Provider Name | Dr. James Wesley Lindsey |
First Address | Independence, MO 64057-1201 |
Second Address | Independence, MO 64057-1201 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/08/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T-73754 | (02) | MO |