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Individual

ROGER G GUTSHALL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DC

Contact information

Practice address
602 LANA DR, SUITE A, CAMERON, MO 64429-1473
(816) 632-6611
(816) 632-6112
Mailing address
602 LANA DR, SUITE A, CAMERON, MO 64429-1473
(816) 632-6611
(816) 632-6112

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
003906
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
75346700
MO
Enumeration date
07/27/2005
Last updated
07/08/2007
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