Provider Demographics
NPI:1174754832
Name:CHANCE, JOLIE RAE (DO)
Entity type:Individual
Prefix:
First Name:JOLIE
Middle Name:RAE
Last Name:CHANCE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:9408 S SAM PETERSON RD
Mailing Address - Street 2:
Mailing Address - City:OAK GROVE
Mailing Address - State:MO
Mailing Address - Zip Code:64075-8344
Mailing Address - Country:US
Mailing Address - Phone:913-488-3408
Mailing Address - Fax:
Practice Address - Street 1:2800 E ROCK HAVEN RD
Practice Address - Street 2:
Practice Address - City:HARRISONVILLE
Practice Address - State:MO
Practice Address - Zip Code:64701-4411
Practice Address - Country:US
Practice Address - Phone:816-380-3474
Practice Address - Fax:816-540-6065
Is Sole Proprietor?:No
Enumeration Date:2009-07-29
Last Update Date:2017-03-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO2009028449207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine