Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | 01-05462 | KS |
NPI | 1114290434 |
---|---|
Provider Name | Dr. Chad A Barnes |
First Address | Overland Park, KS 66210-1617 |
Second Address | Shawnee, KS 66226-3560 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/02/2012 |
Last Update Date | 16/02/2012 |