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General NPI Number Information
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NPI Number | 1720453848
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Entity Type | Individual
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Provider Name | DR. CHAD MARTENS
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Gender | Male
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Dates
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Enumeration Date | 12/01/2015
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Last Update Date | 03/31/2020
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Provider Practice Location Address
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Address Line | 404 E BANNISTER RD STE B
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City | KANSAS CITY
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State | MO
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Zip | 64131-3020
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Country | US
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Telephone | 816-444-1218
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 13242
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City | OVERLAND PARK
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State | KS
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Zip | 66282-3242
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Country | US
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Telephone | 816-444-1218
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Fax |
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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 | 01-05416
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License Number State | KS
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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 | 2008008295
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License Number State | MO
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