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General NPI Number Information
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NPI Number | 1497791479
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Entity Type | Individual
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Provider Name | KEVIN LEE DARDEN CHIROPRACTER
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Gender | Male
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Dates
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Enumeration Date | 06/20/2006
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 5119 E KELLOGG DR
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City | WICHITA
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State | KS
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Zip | 67218-1625
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Country | US
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Telephone | 316-685-0020
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Fax | 316-686-3278
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Provider Business Mailing Address
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Address Line | 5119 E KELLOGG DR
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City | WICHITA
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State | KS
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Zip | 67218-1625
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Country | US
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Telephone | 316-685-0020
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Fax | 316-686-3278
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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 | 01-04612
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License Number State | KS
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