Individual
DR. THAYER BANWART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
4609 PASEO BLVD STE 100, KANSAS CITY, MO 64110-1843
(913) 602-2866
Mailing address
304 SW SEAGULL ST, LEES SUMMIT, MO 64082-4514
(913) 602-2866
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
01-05732
KS
111N00000X
Chiropractor
Primary
2015018443
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1619465945
TYPE 2 ORGANIZATION NPI ARC
MO
01
—
1912577461
TYPE 2 ORGANIZATION NPI PECULIAR CHIROPRACTIC
MO
01
—
58109017
ARC BCBS PROVIDER ID
MO
01
—
65182016
PECULIAR CHIROPRACTIC BCBS PROVIDER ID
MO
Enumeration date
06/19/2015
Last updated
11/15/2022
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