Organization
SUMMIT FAMILY CHIROPRACTIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SETH A KOUBA DC (OWNER)
(816) 246-4325
Entity
Organization
Contact information
Practice address
312 NE HWY 291, LEES SUMMIT, MO 64086
(816) 246-4325
Mailing address
312 NE HWY 291, LEES SUMMIT, MO 64086
(816) 246-4325
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2004017439
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
34831017
BLUE SHIELD OF KANSAS CIT
MO
Enumeration date
08/16/2007
Last updated
08/16/2013
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