Individual
DR. KYLE LESLIE BEANE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
702 OAK ST., LATHROP, MO 64465
(816) 740-6822
(816) 528-6820
Mailing address
702B OAK ST., LATHROP, MO 64465
(816) 740-6822
(816) 528-6820
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2005021276
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
36028017
BLUE CROSS
MO
Enumeration date
05/16/2007
Last updated
07/08/2007
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