Healthcare Provider Details

I. General information

NPI: 1467558676
Provider Name (Legal Business Name): CHASE R CARPENTER DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/15/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

714 MAIN
PLEASANTON KS
66075
US

IV. Provider business mailing address

PO BOX 436 714 MAIN
PLEASANTON KS
66075-0436
US

V. Phone/Fax

Practice location:
  • Phone: 913-352-8344
  • Fax: 913-352-6675
Mailing address:
  • Phone: 913-352-8344
  • Fax: 913-352-6675

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number4776
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number4776
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: