Healthcare Provider Details

I. General information

NPI: 1093586091
Provider Name (Legal Business Name): DANICA RAE WESTMORELAND
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/10/2024
Last Update Date: 01/10/2024
Certification Date: 01/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6524 SE QUAKERVALE RD
RIVERTON KS
66770-4214
US

IV. Provider business mailing address

6524 SE QUAKERVALE RD
RIVERTON KS
66770-4214
US

V. Phone/Fax

Practice location:
  • Phone: 620-848-2380
  • Fax:
Mailing address:
  • Phone: 620-848-2380
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number01-06300
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: