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Individual

DARIC TODD NEUSCHAFER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
2525 GLENN HENDREN DRIVE SUITE 204, LIBERTY, MO 64068
(620) 669-2500
Mailing address
104 PRAIRIE COURT, KEARNEY, MO 64060
(620) 669-2500

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
15-00932
KS
363A00000X
Physician Assistant
Primary
2020000890
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200005140A
KS
Enumeration date
02/10/2006
Last updated
06/03/2021
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