Healthcare Provider Details

I. General information

NPI: 1740375328
Provider Name (Legal Business Name): RALPH STEVEN CARDIN D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 02/01/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9159 W. 133RD ST.
OVERLAND PARK KS
66213
US

IV. Provider business mailing address

9159 W. 133RD ST.
OVERLAND PARK KS
66213
US

V. Phone/Fax

Practice location:
  • Phone: 913-239-8501
  • Fax: 913-239-8601
Mailing address:
  • Phone: 913-239-8501
  • Fax: 913-239-8601

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NI0900X
TaxonomyInternist Chiropractor
License Number01-04542
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: