Provider Demographics
NPI:1174582365
Name:TUCKER, JANET D (DC)
Entity type:Individual
Prefix:DR
First Name:JANET
Middle Name:D
Last Name:TUCKER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:JANET
Other - Middle Name:D
Other - Last Name:RAMAGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:PO BOX 103
Mailing Address - Street 2:
Mailing Address - City:OGDEN
Mailing Address - State:KS
Mailing Address - Zip Code:66517-0103
Mailing Address - Country:US
Mailing Address - Phone:785-223-3388
Mailing Address - Fax:785-537-2636
Practice Address - Street 1:526 RILEY AVE.
Practice Address - Street 2:
Practice Address - City:OGDEN
Practice Address - State:KS
Practice Address - Zip Code:66517-0103
Practice Address - Country:US
Practice Address - Phone:785-223-3388
Practice Address - Fax:785-537-2636
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-17
Last Update Date:2009-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-04535111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS062215Medicare ID - Type UnspecifiedINDIVIDUAL PROVIDER NUMBE