Organization
DECOURCY CHIROPRACTIC CLINIC PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARTIN ST JOHN DECOURCY DC (OWNER PRESIDENT)
(913) 383-3031
Entity
Organization
Contact information
Practice address
10425 MARTY ST, OVERLAND PARK, KS 66061
(913) 383-3031
(913) 383-3041
Mailing address
10425 MARTY ST, OVERLAND PARK, KS 66061
(913) 383-3031
(913) 383-3041
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
0103967
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15338029
BLUE CROSS BLUE SHIELD
—
Enumeration date
06/13/2007
Last updated
08/22/2020
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