Organization
OAK GROVE CHIROPRACTIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JESSICA LYNN VANDERKLEI DC (CO-OWNER/ PRACTICING DOCTOR)
(816) 625-1598
Entity
Organization
Contact information
Practice address
705 S BROADWAY, OAK GROVE, MO 64075-8102
(816) 625-1598
(816) 625-1599
Mailing address
705 S BROADWAY, OAK GROVE, MO 64075-8102
(816) 625-1598
(816) 625-1599
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2017033050
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1164941852
INDIVIDUAL NPI DESIGNATED BY NPPES
—
Enumeration date
07/31/2018
Last updated
12/10/2018
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