Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | 014522 | MO |
NPI | 1134282023 |
---|---|
Provider Name | Dr. Kristine Kae Schrock |
First Address | Saint Joseph, MO 64506-3648 |
Second Address | Saint Joseph, MO 64506-3648 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/12/2006 |
Last Update Date | 08/07/2007 |