Individual
DR. TINA MARIE POULSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DC
Contact information
Practice address
302 SE INDEPENDENCE AVE, LEES SUMMIT, MO 64063-2828
(816) 867-0992
Mailing address
112 E REMINGTON TER, RAYMORE, MO 64083-8537
(816) 724-3361
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2024040714
MO
Other
Enumeration date
10/07/2024
Last updated
10/07/2024
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