Provider Demographics
NPI:1093745481
Name:JOYCE, ALISA ANDERSON (DC)
Entity Type:Individual
Prefix:DR
First Name:ALISA
Middle Name:ANDERSON
Last Name:JOYCE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:ALISA
Other - Middle Name:DYANE
Other - Last Name:ANDERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:21640 MIDLAND DR
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE
Mailing Address - State:KS
Mailing Address - Zip Code:66218-9064
Mailing Address - Country:US
Mailing Address - Phone:913-422-1900
Mailing Address - Fax:913-745-8017
Practice Address - Street 1:21640 MIDLAND DR
Practice Address - Street 2:
Practice Address - City:SHAWNEE
Practice Address - State:KS
Practice Address - Zip Code:66218-9064
Practice Address - Country:US
Practice Address - Phone:913-422-1900
Practice Address - Fax:913-745-8017
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2013-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS4977111N00000X
KS01-04977111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KST52E243Medicare UPIN