Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 006548 | MO |
NPI | 1003875584 |
---|---|
Provider Name | Dr. Steven Christopher Rickman |
First Address | Independence, MO 64055 |
Second Address | Independence, MO 64055-7013 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/03/2006 |
Last Update Date | 13/11/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U68361 | (02) | MO |