Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111NR0200X | Radiology | 01-03725 | KS |
N | 213ER0200X | Radiology | 01-03725 | KS |
N | 111NR0400X | Rehabilitation Chiropractor | 01-03725 | KS |
N | 111NS0005X | Chiropractic Sports Physician | 01-03725 | KS |
NPI | 1336270594 |
---|---|
Provider Name | Dr. Max Dwyane Pfrimmer |
First Address | Leavenworth, KS 66048-2447 |
Second Address | Leavenworth, KS 66048-2447 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/03/2007 |
Last Update Date | 08/07/2007 |