Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | T-00975 | KS |
N | 111NS0005X | Chiropractic Sports Physician | 01-05074 | KS |
NPI | 1346308079 |
---|---|
Provider Name | Dr. Torrence Michelle Gleason |
First Address | Goodland, KS 67735-2942 |
Second Address | Goodland, KS 67735-2942 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/12/2006 |
Last Update Date | 08/01/2021 |