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Organization

RADIANT FAMILY WELLNESS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
STACIE A KREADY (OFFICE MANAGE)
(913) 322-0251
Entity
Organization

Contact information

Practice address
12744 S PFLUMM RD, OLATHE, KS 66062-3664
(913) 322-0251
(816) 817-4861
Mailing address
17701 N US HIGHWAY 169, SMITHVILLE, MO 64089-8609

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
111NP0017X
Pediatric Chiropractor

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
49738011
BLUE CROSS BLUE SHIELD
KS
01
57465021
BLUE CROSS BLUE SHIELD
KS
01
6031765
AETNA
Enumeration date
07/08/2022
Last updated
07/08/2022
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