| NPI | 1972761187 |
|---|---|
| Former Legal Business Name | WALDO CHIROPRACTIC GROUP |
| Entity Type | Organization |
| Authorized Contact | RANDY LEE KELLERMAN President/Owner 816-333-2533 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 33655) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: MO 2007030924) |
| 225100000X Physical Therapist (Licence: MO 20110310891) | |
| Enumeration Date | 2008-05-26 |
| Last Update Date | 2013-03-07 |