Healthcare Provider Details

I. General information

NPI: 1659873099
Provider Name (Legal Business Name): DAKOTA COLE HEGI DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/01/2018
Last Update Date: 02/06/2025
Certification Date: 02/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

614 N MULBERRY RD
DERBY KS
67037-3532
US

IV. Provider business mailing address

866 E ENGLISH CT
DERBY KS
67037-1307
US

V. Phone/Fax

Practice location:
  • Phone: 316-516-8108
  • Fax:
Mailing address:
  • Phone: 316-516-8108
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number01-05890
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: