Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | 01-04589 | KS |
N | 111NS0005X | Chiropractic Sports Physician | 01-04589 | KS |
NPI | 1285698316 |
---|---|
Provider Name | Dr. Wesley A Harden |
First Address | Kingman, KS 67068-9000 |
Second Address | Wichita, KS 67212-2840 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/04/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U75293 | (02) | KS |