Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | C3600 | KS |
Y | 111NX0800X | Chiropractor Orthopedic Specialist | C3600 | KS |
NPI | 1568461408 |
---|---|
Provider Name | Dr. John Eric Rasmussen |
First Address | Prairie Village, KS 66208-3501 |
Second Address | Prairie Village, KS 66208-3501 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2005 |
Last Update Date | 12/05/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T42338 | (02) | KS |