Organization
EASTPORT CHIROPRACTIC, LLC
Active
Other names
Eastport Chiropractic
Organization subpart
No
Provider details
NPI number
Authorized official
SYRECE SHERMAN DC (OWNER)
(816) 277-6815
Entity
Organization
Contact information
Practice address
4025 NE LAKEWOOD WAY STE 100, LEES SUMMIT, MO 64064-2058
(816) 598-4363
(816) 709-3074
Mailing address
4025 NE LAKEWOOD WAY STE 100, LEES SUMMIT, MO 64064-2058
(816) 598-4363
(816) 709-3074
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
50218029
BLUE CROSS OF KANSAS CITY
—
Enumeration date
05/30/2019
Last updated
12/10/2019
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