Provider Demographics
NPI:1144366550
Name:INTEGRITY CHIROPRACTIC TR
Entity type:Organization
Organization Name:INTEGRITY CHIROPRACTIC TR
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:TRUSTEE
Authorized Official - Prefix:DR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:D
Authorized Official - Last Name:PATTISON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:816-524-1212
Mailing Address - Street 1:714 SE THIRD STREET
Mailing Address - Street 2:
Mailing Address - City:LEE'S SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64063
Mailing Address - Country:US
Mailing Address - Phone:916-524-1212
Mailing Address - Fax:
Practice Address - Street 1:714 SE 3RD ST
Practice Address - Street 2:
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64063-2815
Practice Address - Country:US
Practice Address - Phone:816-524-1212
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2012-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2011015868111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1144366550OtherNPI FOR GROUP