Healthcare Provider Details

I. General information

NPI: 1639331879
Provider Name (Legal Business Name): RYAN L DANSEL CHIROPRACTIC PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/30/2008
Last Update Date: 06/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1250 W AMITY ST
LOUISBURG KS
66053-7815
US

IV. Provider business mailing address

1250 W AMITY ST
LOUISBURG KS
66053-7815
US

V. Phone/Fax

Practice location:
  • Phone: 913-837-4646
  • Fax: 913-837-4643
Mailing address:
  • Phone: 913-837-4646
  • Fax: 913-837-4643

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number4789
License Number StateKS

VIII. Authorized Official

Name: DR. RYAN L DANSEL
Title or Position: OWNER
Credential: DC
Phone: 913-837-4646