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Individual

DR. ROGER WAYNE OTT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
600 W 103RD ST, SUITE 201, KANSAS CITY, MO 64114-4560
(816) 941-4128
(816) 524-3150
Mailing address
600 W 103RD ST, SUITE 201, KANSAS CITY, MO 64114-4560
(816) 941-4128
(816) 524-3150

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
005329
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
12731011
BLUE CROSS/BLUE SHIELD
MO
01
5214444
AETNA
MO
Enumeration date
07/23/2006
Last updated
07/08/2007
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