Doctor Name: | DR. REID S KETTELER |
NPI Number: | 1811090483 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | DC |
License Number: | 4670 |
Business Practice Address: | 5548 Hedge Lane Terrace Shawnee, KS - 66226 |
Business Phone Number: | 9134228929 |
Business Fax Number: | 9134220061 |
Mailing Address: | 5363 Roberts St, SHAWNEE |
State: | KS |
Postal Code: | 662263938 |
Phone Number: | 9134228929 |
Fax Number: | 9134220061 |
NPI Enumeration Date: | 09/07/2006 |
NPI Last Update Date: | 01/10/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 111N00000X |
License Number: | 4670 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | KS |
Taxonomy Type: | Chiropractic Providers |
Taxonomy Classification: | Chiropractor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |