Organization
KC SPINE, LLC
Active
Other names
Clear Wave Chiropractic, KC Spine
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CAMEON M BLAKE DC (OWNER / CHIROPRACTOR)
(913) 475-5193
Entity
Organization
Contact information
Practice address
1707 E CEDAR ST STE 108, OLATHE, KS 66062-1886
(913) 318-3003
Mailing address
12482 SLATER LN, OVERLAND PARK, KS 66213-1773
(913) 475-5193
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
01-05902
KS
Other
Enumeration date
07/13/2018
Last updated
03/19/2019
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