Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | 01-04047 | KS |
NPI | 1063622983 |
---|---|
Provider Name | Dr. Gail J. Boyer |
First Address | Lenexa, KS 66215-1668 |
Second Address | Lenexa, KS 66215-1668 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/05/2007 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
18765018 | BCBS PROVIDER # (01) | KS |
U21224 | (02) | KS |