Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NP0017X | Pediatric Chiropractor | 01-05783 | KS |
NPI | 1932563830 |
---|---|
Provider Name | Jennifer Santa Maria |
First Address | Overland Park, KS 66085-8240 |
Second Address | Overland Park, KS 66085-8240 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/04/2016 |
Last Update Date | 07/04/2016 |