Provider Demographics
NPI:1073127932
Name:NORTH, CHET BRIAN
Entity Type:Individual
Prefix:
First Name:CHET
Middle Name:BRIAN
Last Name:NORTH
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 1:1913 PINNACLE WAY
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66111-7100
Mailing Address - Country:US
Mailing Address - Phone:816-665-8443
Mailing Address - Fax:
Practice Address - Street 1:1913 PINNACLE WAY
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66111-7100
Practice Address - Country:US
Practice Address - Phone:816-665-8443
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-08
Last Update Date:2020-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS24-012792255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer