Provider Demographics
NPI:1184034514
Name:FUNK, DAREK EUGENE (DC)
Entity Type:Individual
Prefix:MR
First Name:DAREK
Middle Name:EUGENE
Last Name:FUNK
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:PO BOX 501
Mailing Address - Street 2:
Mailing Address - City:MARYSVILLE
Mailing Address - State:KS
Mailing Address - Zip Code:66508-0501
Mailing Address - Country:US
Mailing Address - Phone:785-562-1900
Mailing Address - Fax:785-562-1902
Practice Address - Street 1:1124 PONY EXPRESS HWY
Practice Address - Street 2:
Practice Address - City:MARYSVILLE
Practice Address - State:KS
Practice Address - Zip Code:66508-8647
Practice Address - Country:US
Practice Address - Phone:785-562-1900
Practice Address - Fax:785-562-1902
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-07
Last Update Date:2014-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2014013456111N00000X
KS0105647111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor