Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | 01-05122 | KS |
NPI | 1033303136 |
---|---|
Provider Name | Dr. Casey T Hummel |
First Address | Austin, TX 78766-1053 |
Second Address | Andover, KS 67002 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2007 |
Last Update Date | 24/06/2011 |