Provider Demographics
NPI:1023297488
Name:VAN METER, NOELLE PETIT (BS, DC)
Entity type:Individual
Prefix:DR
First Name:NOELLE
Middle Name:PETIT
Last Name:VAN METER
Suffix:
Gender:F
Credentials:BS, DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:244 E US HIGHWAY 69
Mailing Address - Street 2:SUITE 202
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64119-3115
Mailing Address - Country:US
Mailing Address - Phone:816-453-1198
Mailing Address - Fax:816-453-0381
Practice Address - Street 1:244 E US HIGHWAY 69
Practice Address - Street 2:SUITE 202
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64119-3115
Practice Address - Country:US
Practice Address - Phone:816-453-1198
Practice Address - Fax:816-453-0381
Is Sole Proprietor?:No
Enumeration Date:2007-11-01
Last Update Date:2008-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2007034035111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOW68F739Medicare PIN