Provider Demographics
NPI:1033535695
Name:RAY, MICHAEL L
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:L
Last Name:RAY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7575 W 106TH ST
Mailing Address - Street 2:396
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66212-5920
Mailing Address - Country:US
Mailing Address - Phone:620-770-0067
Mailing Address - Fax:
Practice Address - Street 1:1145 N ANDOVER RD STE 109
Practice Address - Street 2:
Practice Address - City:ANDOVER
Practice Address - State:KS
Practice Address - Zip Code:67002
Practice Address - Country:US
Practice Address - Phone:316-361-0620
Practice Address - Fax:316-665-4457
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-06
Last Update Date:2019-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-05628111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor