Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | 01-05660 | KS |
Y | 111NP0017X | Pediatric Chiropractor | 01-05660 | KS |
NPI | 1114320215 |
---|---|
Provider Name | Dr. Madison D Gilbert |
First Address | Overland Park, KS 66210-1401 |
Second Address | Overland Park, KS 66210-1401 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/10/2014 |
Last Update Date | 02/10/2014 |