Individual
DAVID HATHAWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CPED
Contact information
Practice address
7410 WORNALL RD, KANSAS CITY, MO 64114-1540
(800) 471-8592
Mailing address
7410 WORNALL RD, KANSAS CITY, MO 64114-1540
(800) 471-8592
Taxonomy
Speciality
Code
Description
License number
State
211D00000X
Podiatric Assistant
Primary
2899
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2899
BOARD PEDORTHICS
DE
Enumeration date
01/25/2008
Last updated
01/25/2008
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