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General NPI Number Information
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NPI Number | 1184034514
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Entity Type | Individual
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Provider Name | DAREK EUGENE FUNK D.C.
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Gender | Male
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Dates
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Enumeration Date | 05/07/2014
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Last Update Date | 10/27/2014
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Provider Practice Location Address
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Address Line | 1124 PONY EXPRESS HWY
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City | MARYSVILLE
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State | KS
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Zip | 66508-8647
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Country | US
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Telephone | 785-562-1900
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Fax | 785-562-1902
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Provider Business Mailing Address
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Address Line | PO BOX 501
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City | MARYSVILLE
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State | KS
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Zip | 66508-0501
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Country | US
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Telephone | 785-562-1900
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Fax | 785-562-1902
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 2014013456
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 0105647
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License Number State | KS
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