Provider Demographics
NPI:1083499024
Name:NORTON, GAVIN RICHARD (DC)
Entity Type:Individual
Prefix:
First Name:GAVIN
Middle Name:RICHARD
Last Name:NORTON
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 1:904 ALLYSSA CT
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:KS
Mailing Address - Zip Code:66043-5207
Mailing Address - Country:US
Mailing Address - Phone:785-218-5046
Mailing Address - Fax:
Practice Address - Street 1:12980 W 87TH STREET PKWY
Practice Address - Street 2:
Practice Address - City:LENEXA
Practice Address - State:KS
Practice Address - Zip Code:66215-2890
Practice Address - Country:US
Practice Address - Phone:913-227-0909
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-29
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0106277111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor