Provider Demographics
NPI:1033168752
Name:WINTERS, TODD JAMES (DC)
Entity Type:Individual
Prefix:
First Name:TODD
Middle Name:JAMES
Last Name:WINTERS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:802 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:GARDNER
Mailing Address - State:KS
Mailing Address - Zip Code:66030-1287
Mailing Address - Country:US
Mailing Address - Phone:913-856-8135
Mailing Address - Fax:913-856-8135
Practice Address - Street 1:802 E MAIN ST
Practice Address - Street 2:
Practice Address - City:GARDNER
Practice Address - State:KS
Practice Address - Zip Code:66030-1287
Practice Address - Country:US
Practice Address - Phone:913-856-8135
Practice Address - Fax:913-856-8135
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-09
Last Update Date:2011-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-04455111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100454150AMedicaid
KSU72458Medicare UPIN
KS000B274Medicare ID - Type Unspecified